{
  "abstract": "Background and Aims Pain, nausea, and vomiting are common concerns in post-operative period after caesarean section. Opioids used as adjuvants to spinal anaesthesia contribute to it. The study aimed to compare dexamethasone’s antiemetic potential for prophylaxis through intravenous and intrathecal routes.Methods In this prospective randomized double-blinded study, patients were administered dexamethasone 4 mg either through intrathecal route as an adjuvant with 1.5 ml bupivacaine heavy (0.5%) (group A) or through intravenous route (group B) and compared with control group (group C), which received normal saline through both routes. Primary objective was to compare incidence of postoperative nausea and vomiting. Secondary objectives were total sensory block duration, time to first rescue analgesic, total analgesic consumption, postoperative pain scores(VAS), and patient satisfaction.Results Of 30 patients per group, three patients each in intravenous and intrathecal groups (10%), and nine patients (30%) in control group had nausea, difference being statistically insignificant. Vomiting occurred in one patient (3%) and two patients (6.67%) in intrathecal and intravenous groups, respectively, when compared to nine patients (30%) in control group, difference being statistically significant. Post hoc analysis states that intrathecal dexamethasone has significant role in control of vomiting (corrected P = 0.036) while intravenous dexamethasone does not have same effect (corrected P = 0.123). There was significant difference in sensory block duration among groups (A - 79.03 (+/-6.35 minutes, B- 65.97 +/-4.78 minutes, C- 60.63+/- 2.97 minutes). Time to first analgesic was significantly longer, and resting VAS scores were significantly less in dexamethasone groups. Total analgesic requirement had significant difference between intrathecal and control group but not among intravenous dexamethasone and control group.Conclusions Intrathecal dexamethasone is associated with lesser incidence of postoperative vomiting than same dose of intravenous dexamethasone. Patients‘ overall satisfaction is significantly better in intrathecal group due to lesser incidence of vomiting, better pain scores and lesser analgesic consumption.",
  "authors": [
    {
      "affiliations": [
        "Senior Resident CCM, All India Institute of Medical Sciences, Jodhpur, Jodhpur, India"
      ],
      "name": "Mukund Sajjan"
    },
    {
      "affiliations": [
        "All India Institute of Medical Sciences, Jodhpur, Jodhpur, India"
      ],
      "name": "Bharat Paliwal"
    },
    {
      "affiliations": [
        "Professor and Head, All India Institute of Medical Sciences, Jodhpur, Jodhpur, India"
      ],
      "name": "Pradeep Bhatia"
    },
    {
      "affiliations": [
        "Professor, All India Institute of Medical Sciences, Jodhpur, Jodhpur, India"
      ],
      "name": "Manoj Kamal"
    },
    {
      "affiliations": [
        "Professor, All India Institute of Medical Sciences, Jodhpur, Jodhpur, India"
      ],
      "name": "Nikhil Kothari"
    }
  ],
  "title": "EP157 Comparison of the effect of intravenous and intrathecal dexamethasone on prevention of postoperative nausea and vomiting in patients posted for caesarean section: a randomized controlled trial",
  "uid": "0c9e660b-ac07-5599-8755-a0c40b5de52c"
}