ABSTRACT : : Post-operative vomiting (POV) being one of the most common complications of tonsillectomy, has led to an increased use of anti-emetic drugs. There is paucity of literature on the anti-emetic effect of super-hydration as a prophylactic modality. The objective of the study was to evaluate the effect of super-hydration with lactated Ringer’s solution (RL) on reducing POV in children undergoing tonsillectomy.

METHODS : : A randomised single blinded controlled study was conducted in a tertiary care hospital. A total of 100 patients, aged 1-12years of ASA physical status I-II, undergoing elective tonsillectomy under general anaesthesia were included and randomised into two groups. Induction and maintenance of anaesthesia were standardized for all. Patients received either 10 ml/kg/hr(Group A) or 30 ml/kg/hr(Group B) of lactated Ringer’s solution, from the commencement of surgery upto one hour and patients were observed post-operatively for 24 hours for the effect of super-hydration on retching, vomiting or both.

RESULTS : Each group comprised 50 patients and baseline characteristics of the groups were well matched. During first 24 hour postoperative period, the incidence of POV was 40/ 50 patients in group A as compared to 27 of 50 in group B (80% vs 54%;p<0.05), hence it is statistically significant as analysed by logistic regression.

CONCLUSIONS : Intraoperative super-hydration reduces gut mucosal hypoperfusion and ischaemia, consequently reducing the serotonin production and its activation of CTZ leading to reduction in POV.