Title: Role of intravenous dextrose on reducing postoperative nausea and vomiting in children undergoing tonsillectomy and /or adenoidectomy: A randomized, double-blind, controlled study
Aidah Alkaisssi¹, Ahmad Nassar², Nouraldin Almasri³
¹ An-Najah National University, Faculty of Medicine and Health Sciences, Nursing and Midwifery Department, Nablus- Palestine
²An-Najah National University, Faculty of Graduate Studies, Nablus- Palestine
³ Rafidia Hospital, Ministry of Health, Nablus-Palestine
Aim: To evaluate whether the postoperative IV administration of 5% dextrose water following surgery decreases postoperative symptoms focusing on PONV in patients undergoing tonsillectomy and /or adenoidectomy. Methods: Prospective, randomized double-blind, controlled study. Ninty Pediatric patients undergoing adeno/tonsillectomy were randomly assigned into two groups (n = 45 each). Dextrose water (DW) and ringer lactate (RL) groups. The incidence of postoperative symptoms was assessed. Results: The incidence of nausea at 30 min postoperatively in DW group was significantly lower 3(6.7%) than RL group 26(57.8%), p=- 0.000. At one hour, the incidence of nausea in the DW group 7(15.6%) was significantly lower than RL group 21(46.7%), p= .001. At overall period the incidence of nausea (0-5 hours) in DW group 22(48.9%) was significantly lower than the RL group 35(77.8%), (P-value 0.004). At 30 minutes postoperatively, M±S.D of VAS-N scale in the DW group (0.27+0.81) is significantly lower than the RL group(1.6+1.57), p=0.000. At one hour, in the DW group (0.31±0.73) is significantly lower than the RL group 1.07+1.25, p= 0.001. At discharge from the hospital, in the DW group (0.04±0.3) is significantly lower than the RL group(0.4+0.91), p=0.015. There is a significant difference in the use of rescue anti-emetic medication throughout the study period between the dextrose group 7 (15.6%) compared to Ringer lactate group 17 (37.8%), p = 0.017. Dextrose Water reduces significantly the incidence of post-operative symptoms that are headache, drowsiness, fatigue, thirst and hunger compared to the RL group, p <0.05. Conclusion: The administration of intravenous dextrose postoperatively for patients undergoing adeno / tonsillectomy reduces significantly the incidence and intensity of nausea, the incidence of headache, drowsiness, fatigue, thirst and hunger.
Key words: Postoperative nausea; vomiting; postoperative symptoms; dextrose water