Intravenous Dexmedetomidine versus Dexmedetomidine-Dexamethasone Combination: A Comparative Study on Postoperative Nausea and Vomiting After Abdominal Surgeries

Abstract

Background: Postoperative nausea and vomiting (PONV) is a frequent problem after abdominal surgeries. It delays recovery and increases patient discomfort. Dexmedetomidine has some antiemetic effect due to sympathetic block. Dexamethasone is also a well-known antiemetic drug.

Objective: To compare the effect of intravenous dexmedetomidine versus dexmedetomidine-dexamethasone combination on PONV after abdominal surgeries.

Study Design: Comparative observational study.

Place and Duration: Khyber Medical University-Institute of Medical Sciences, DHQ Teaching Hospital KDA Kohat, Pakistan. Study duration was 6 months from July 2025 to December 2025.

Methodology: Total 120 patients were included using non-probability consecutive sampling. Patients were divided into two equal groups. Group A received dexmedetomidine alone. Group B received dexmedetomidine with dexamethasone. PONV was observed for 24 hours after surgery. Data were analyzed using SPSS 26. Chi-square and t-test were applied. P-value ≤0.05 was considered significant.

Results: Overall PONV was significantly lower in Group B (23.3%) compared to Group A (46.7%) with p value 0.008. Nausea in early period was 16.7% vs 33.3%. Vomiting incidence was 11.7% vs 30%. Moderate and severe PONV were also reduced in combination group. Duration of surgery and opioid use were similar in both groups. Previous studies also show dexmedetomidine reduces PONV by lowering opioid requirement and stress response, and dexamethasone improves antiemetic effect through central pathways.

Conclusion: Dexmedetomidine plus dexamethasone is more effective than dexmedetomidine alone in reducing PONV after abdominal surgery.