A Study of Single Dose Dexamethasone in Reducing Postoperative Sore Throat, Nausea and Vomiting in Patients Receiving General Anaesthesia for C a Esarean Section

Abstract

Postoperative sore throat and nausea and vomiting are common complaints in patients undergoing surgery, under general endotracheal anesthesia. Some of the studies have shown potential advantages of dexamethasone in prevention of postoperative sore throat. We therefore undertook a study to evaluate the efficacy of dexamethasone 8 mg administration intravenously, in reducing the incidence and severity of postoperative sore throat nausea and vomiting in patients undergoing caesarean section under general anesthesia with endotracheal intubation. METHODS: In a randomized, double blind and placebo controlled study, 60 patients receiving general anesthesia with endotracheal intubation undergoing caesarean section were randomly assigned to two groups. Group-I, patients received dexamethasone 8 mg IV and group-II received normal saline 2 ml IV. After surgery VAS score was used to assess sore throat and nausea, number of episodes of vomiting were recorded by a blinded observer. RESULTS: The overall incidence and severity of postoperative sore throat was less at all times in study group as compared to control group (p<0.001). 22 of 30 patients in dexamethasone group had sore throat as compared to 28 of 30 patients in control group (p<0.05). Even though there was no difference in the incidence of nausea in early postoperative period as compared to delayed postoperative period, there was significant reduction in severity of nausea in delayed and early postoperative period (p<0.001). There was no difference in incidence (p>0.05), but severity of vomiting was less in early postoperative period in dexamethasone group (p<0.001). There was significant reduction in incidence and severity of dexamethasone group in delayed postoperative period. CONCLUSION: Single dose dexamethasone reduces the incidence and severity of postoperative sore throat, nausea and vomiting in patients undergoing caesarean section under general endotracheal anesthesia.

Effect of dexamethasone on reducing pain and gastrointestinal symptoms associated with cesarean section: a systematic review and meta-analysis

“…(Figure 1) The included studies had a combined total population of 2840 patients, 1560 in dexamethasone groups and 1280 in placebo groups. Some studies used dexamethasone 8 mg by IV route,1 1,13,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] while others used 16 mg dexamethasone by both SC and IV routes as separate groups. 36,37 One study reported three dexamethasone groups using various doses (2.5 mg, 5 mg, and 10 mg) by IV route.…”

“…40 Some studies introduced the intervention preoperatively, 11,13,23,27,28,30,34 while other studies introduced the intervention intraoperatively. 21,22,[24][25][26]29,[31][32][33]35,37,38,41 The remaining studies introduced the intervention post-operatively. 20,36,39 One study did not report the time of administration.…”

“…With regard to random sequence generation, all studies were at low risk for bias except for seven studies rated at unclear bias as they did not report sufficient information. 24,27,28,30,32,35,38 In most of the studies included in this research, the allocation concealment process was clearly stated. 20,29,[31][32][33]40,41 However, seventeen of the randomized, controlled studies (RCTs) used had unclear risk as authors did not indicate if they performed allocation concealment.…”

“…20,29,[31][32][33]40,41 However, seventeen of the randomized, controlled studies (RCTs) used had unclear risk as authors did not indicate if they performed allocation concealment. 11,13,[21][22][23][24][25][26][27][28]30,[34][35][36][37][38][39] All studies showed low-risk performance bias with regard blinding of participants and personnel. While almost all studies demonstrated blinding of outcome assessors, four studies did not report enough information to determine the extent of blinding.…”

“…21,23,29,30,33,34,36,38,39,41 Eight studies had unclear risk; two did not evaluate P-values for rescue analgesic outcomes, 20,25 and six studies did not publish protocols. 11,13,22,24,26,32 The rest of the studies showed high risk for adjusted small sample size, 27,28,31,32,40 and for ending before completing enrollment of their subjects. 35 More than ten studies reported three outcomes; therefore, publication bias estimation was possible.…”