Comparison of Dexamethasone and Local Anaesthetic Infiltration in Management of Postoperative Nausea and Vomiting in Pediatric Tonsillectom

Objective: Comparison of the effectiveness of intravenous Dexamethasone and pre-incision infiltration of local anesthetic among Pediatric tonsillectomy patients in reduction of postoperative nausea, vomiting, and pain. Study Design: Quasi-Experimental Study. Place and Duration of Study: Combined Military Hospital, Rawalpindi, Pakistan, from Jan to Jun 2022. Methodology: Pediatric patients aged 04 to 13 years undergoing tonsillectomy under general anesthesia were enrolled in the study. Group-A was administered intravenous Dexamethasone 0.5 mg/kg (up to 16 mg), and Group-B was administered a 24ml of local anesthesia as pre-incision infiltration. Results: A total of 126 patients enrolled in the study, with equal distribution in each group. In the post-anesthesia recovery unit, 10(15.9%) of patients in Group-A had vomiting, whereas 2(3.2%) in Group-B experienced vomiting (p-value 0.03). After 24 hours, the PONV frequency rose to 17(27.0%) and 6(9.5% respectively, in Group-A and Group-B (p-value 0.02), with compatible results at 48 hours, 3rd, 4th, and 5th day postoperatively. Group-A has shown higher consumption of postoperative analgesics in post post-anesthesia recovery unit and throughout from 1st to 5th day. 10(16.2%) and 21(32.8%) patients in Groups A and B, respectively, were able to drink during their PACU stay (p-value 0.05). Conclusion: Local anesthetic infiltration is an effective modality for reduction of postoperative nausea and vomiting, along with analgesic potential in Pediatric patients undergoing tonsillectomy under general anesthesia.