Dexamethasone Prophylaxis on Incidences of Post-Operative Nausea and Vomiting (Ponv) in Patients Undergoing Gynecological Surgeries Under Spinal Anesthesia

Abstract

Nausea and vomiting are the most common distressing symptom in the post-operative period. It can result in delayed hospital discharge and increased hospital cost. The present study was done to assess the effect of dexamethasone prophylaxis on the incidences of nausea and vomiting in post-operative period in patients undergoing gynecological surgeries. MATERIAL AND METHODS: A total number of 66 patients, aged between 20 to 65 years, posted for elective gynecological surgeries under spinal anesthesia were included in the study. Patients were randomized into two groups of 33 patients each, and the study group (group-D) received Inj. Dexamethasone 8 mg intravenously as prophylactic antiemetic 1 hour before surgery whereas control group (group-N) received normal saline. Post-operatively, the frequency of nausea and vomiting were observed and its influences on postoperative analgesia were also noted. RESULTS: In our study, 4(12.1%) patients in group-D and 8(24.2%) patients in group-N had nausea and vomiting in the intraoperative period (p value=0.202). 24.2% patients in group-D had vomiting in the postoperative period as compared to 72.7% in group-N and group D patients had significant reduction in incidences of nausea and vomiting in immediate post-operative period compared to group N (p-value 0.016). Accordingly, the mean requirement of rescue antiemetic was less in group-D compared to Group-N. Further, patients in group-D had better VAS scores compared to patients in group-N in post-operative period. CONCLUSION: Use of Dexamethasone prior to subarachnoid block in patients undergoing gynecological surgeries reduces the incidence of nausea and vomiting and the requirement of antiemetic in the postoperative period, and better post-operative analgesia.