Effects of preoperative dexamethasone on postoperative nause and vomiting, pain, upper airway symptoms and quality of recovery

Dexamethasone is a glucocorticoid recommended by current guidelines for the prevention of postoperative nausea and vomiting. Additionally, there are studies suggesting that dexamethasone reduces postoperative pain and upper airway symptoms while improving recovery quality. This study aimed to evaluate the effectiveness of a single preoperative dose of dexamethasone in preventing postoperative nausea and vomiting, as well as its other potential benefits. After obtaining ethical committee approval, 127 patients aged 18-65 years, with ASA pyhysical status 1-2, scheduled for elective laparoscopic cholecystectomy and laparoscopic hysterectomy under general anesthesia, were included in the study. The QoR-40 (Quality of Recovery) questionnairre was admiminstered preoperatively to all patients. After the patients were divided into two groups, those in the dexamethasone group received 0,1 mg/kg IV dexamethasone before anesthesia induction, while those in the control group received 2 ml IV normal saline. Postoperative nausea and vomiting, pain and upper airway symptom scores, as well as the need for additional antiemetics and analgesics, were noted at 1 and 24 hours postoperatively. Additionally, the QoR-40 questionnaire was administered at the 24th postoperative hour. The incidence of postoperative 1st hour PONV (%30.1 vs. %53.2, respectively; p=0.011) and the need for additional antiemetics (6/63 vs. 20/64; p=0.002) were lower in the dexamethasone group. Although there was no difference in nausea scores at the 24th hour, the control group required more rescue antiemetics (17/63 vs. 33/64; p=0.005). The pain score was significantly lower in the dexamethasone group only at the 24th hour (1.59±0.71 vs. 2.02±0.79; p=0,002), while additional analgesic use, upper airway symptoms, and recovery quality were similar between the groups. In conclusion, it was determined that a single preoperative intravenous dose of 0.1 mg/kg dexamethasone reduces postoperative nausea and vomiting as well as the need for additional antiemetics but does not provide significant benefits in terms of pain, additional analgesic consumption, upper airway symptoms, or recovery quality.