A comparative study of the effect of intranasal dexamethasone and normal saline on the occurrence of nausea and vomiting after hysterectomy: a clinical trial study

Background. Many studies have been performed to prevent nausea and vomiting after surgery with different drugs alone or in combination, but no definite answer has been given yet. This study was performed to evaluate the effect of an intranasal dose of dexamethasone on the prevention of nausea and vomiting after hysterectomy.

Methods. In this clinical trial study, 70 patients undergone hysterectomy were randomly distributed into two groups of 35, and immediately after intubation, in the intervention group 0.5 ml of dexamethasone in each nostril (total 4mg) and in the control group 0.5 ml of distilled water was dripped in each nasal passage. Patients in the two groups were evaluated and compared during recovery and at 2, 12, and 24 hours after entering the ward for the incidence and severity of postoperative nausea and vomiting and receiving anti-emetic medication.

Results. The incidence of nausea and vomiting in recovery and ward was not significantly different between the two groups so that 3 patients in the distilled water group and 1 patient in the dexamethasone group experienced nausea in recovery (9.7% and 3.2%, respectively). The incidence of vomiting in recovery was 3 cases, all 3 cases (9.7%) were distilled water group. The severity of nausea in recovery (P= 0.55), in the second hour of admission (P= 0.12), in the next 12 hours (P= 0.19), and 24 hours later (P= 0.46) was not significantly different between the two groups. Conclusion. Intranasal dexamethasone (4 mg) is associated with an insignificant reduction in the incidence of PONV in post-hysterectomy pain.

Practical Implications. Intranasal dexamethasone administration is a safe and effective method and can be associated with reduced incidence of nausea and vomiting and pain after hysterectomy.