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.

A randomised single blinded controlled study was conducted in a tertiary care hospital. 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 RL, 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.

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 observed in 40 of 50 patients in group A as compared to 27 of 50 in group B (80% vs 54%;p<0.05), statistically significant as analysed by logistic regression.

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

PONV, super-hydration, vomiting, antiemetics