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Background. Postoperative nausea and vomiting (PONV) remain as common and unpleasant and highly distressful experience following ear, nose, and throat surgery. During ENT surgery, the incidence of PONV could be significantly reduced in patients who receive dexamethasone and propofol as prophylaxis. However, the comparative effectiveness of the two drugs has not been assessed. The aim of this study was to compare the effectiveness of propofol and dexamethasone for prevention of PONV in ear, nose, and throat surgery. Methods. This study was conducted in 80 patients, with ASA I and II, aged 18–65 years, and scheduled for ENT surgery between December 20, 2017, and March 20, 2018. Patients were randomly assigned to Group A and Group B. Immediately after the procedure, Group A patients received single dose of intravenous (IV) dexamethasone (10 mg/kg) and Group B patients were given propofol (0.5 mg/kg, IV), and equal follow-up was employed. The incidence of PONV was noted at 6th, 12th, and 24th hour of drug administration. Independent t-test and Mann–Whitney test were used for comparison of symmetric numerical and asymmetric data between groups, respectively. Categorical data were analyzed with the chi-square test, and p value of < 0.05 was considered as level of significance. Results. The incidences of PONV throughout the 24-hour postoperative period were 35% in the propofol group and 25% in the dexamethasone group. Statistical significance was found in incidence of PONV (0% versus 22.5%) and use of antiemetic (0% versus 5%) between dexamethasone and propofol groups, respectively, at 12–24 hours. Over 24 hours, 5% in dexamethasone group and 12.5% in propofol group developed moderate PONV, while none of the participants felt severe PONV. Conclusions. Dexamethasone was more effective than propofol to prevent PONV with lower requirements of rescue antiemetics.

Background: Laryngeal mask airway (LMA) is a useful airway device which provides an alternative to ventilation through a face mask or endotracheal tube during ophthalmic surgery. It can be removed either when a child awakens or deeply anesthetized. But there is little evidence for best practice on the timing of their removal after ophthalmic surgery in the pediatric population. It has been studied by various investigators but with conflicting results and conclusions. Objective: The aim of this study was to evaluate the effect of depth of anesthesia (awake or deep anesthesia) on the incidence of airway associated complications during LMA removal. Methodology: A prospective observational cohort study was conducted from January to April 2018. Sixty-two American Society of Anesthesiologists physical status I and II pediatric (aged 2-8 years) patients who underwent ophthalmic procedures under general anesthesia with LMA were recruited. Grouping (awake group or deep group) was done based on independent decision of on duty anesthetist and halothane 1-1.5% was used as maintenance anesthesia. The incidence of airway-related adverse events like coughing, upper airway obstruction (Laryngospasm), breath holding, desaturation, excessive salivation, biting, vomiting, and retching with LMA removal were evaluated. Collected data were entered into Epi Info™ version 7.0 and transported to the SPSS version 22 for analysis. Fisher's exact test and Chi-square test were used to analyze dependent variables and P-values less than 0.05 were considered statistical significance. Results: There were no significant differences in airway-related adverse events. The incidence of coughing (12.9%, 6.5%), upper airway obstruction (41.9%, 35.5%), breath holding (9.7%, 3.2%), desaturation (16.1%, 22.6%), excessive salivation (19.4%, 12.9%), and biting (6.5%, 0%) between awake and deep groups respectively with (p > 0.05). Laryngospasm, vomiting, and retching did not occur in either group. Conclusion: There was no significant difference in the incidence of airway-related adverse events whether the LMA was removed in a deep or awake condition.

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