Randomized study for evaluation of timing of injection dexamethasone on its efficacy as prophylactic antiemetic in laparoscopic surgery

Abstract

Background:-Patients undergoing laparoscopic surgeries are highly susceptible for postoperative nausea and vomiting (PONV). PONV prophylaxis is must for these patients.Many drugs are used for prophylaxis of PONV in these patients and dexamethasone is one of the cost effective drug amongst all.Aim and objectives:- To asses effect of timing of injection dexamethasone administration on its efficacy as prophylactic antiemetic for post operative nausea and vomiting in patients undergoing laparoscopic surgery.Material and methods:- 240 patients of ASA grade I were posted for laparoscopic surgeries under general anaesthesia.These patients were randomly allocated in group 1( pre induction) and group 2 (post extubation)of 120 each.group 1 received inj.dexamethasone 8 mg 30 minutes before induction while group 2 received inj. Dexamethasone 8 mg after extubation.Patients were observed for 24 hrs for episodes of nausea, vomiting and need for rescue antiemetic and for 48 hrs for side effects of steroid. Study results were analyzed by Unpaired “t” test and categorical data was analyzed by chi-square test. A p-value of less than 0.05 was considered for statistical significance.Results:-It was found that in the first 2 hours as well as beween 2-6 hours after surgery ,incidence of nausea and vomiting was significantly less in group 1 as compared to group 2. Beween 6-24 hours after surgery , incidence of nausea was significantly less in group 1 than group 2 but there was no significant difference in the incidence of vomiting between the two groups.Rescue antiemetic was needed in 25% of patients in group 1 and 63.33% patients in group 2 (p=0.001). No adverse effects was seen in either of the groups.Conclusion:-This study results show that prophylactic therapy with inj. Dexamethasone (8mg) given before induction significantly reduces early as well as late post operative nausea and vomiting in patients undergoing laparoscopic surgeries.