For a study, researchers wanted to determine how a single dose of preoperative dexamethasone affected postoperative nausea and vomiting (PONV), a common complication and a primary cause of delayed recovery in pediatric UGIE under sedation. About 98 children aged 2 to 14, with American Society of Anesthesiologists status I to II and receiving elective UGIE with heavy sedation, participated in the double-blind, randomized controlled trial and were randomly assigned to two groups. Patients in the intervention (n=49) and control (n=49) groups received 0.1 mg/kg i.v. dexamethasone and 2 cm3 i.v. 0.9% saline, respectively, after anesthesia induction with sodium thiopental and maintenance with sevoflurane. The primary outcome was the occurrence of PONV after surgery. 

PONV incidence was considerably lower (8.2%) in the dexamethasone group compared to the control group (26.5%) (difference=18.3%, 95% CI: 3.4% 33%, P=0.016). Secondary outcomes showed no statistically significant differences between groups: incidence of bronchospasm or laryngospasm (both 4.1%, P=1); emergence delirium assessed with the Pediatric Anesthesia Emergence Delirium scale (5.9+3.4 vs 5.7+ 3.2, P=0.751); Modified Aldrete score at 0 minutes (9.4±0.8 vs 9.3±0.9, P=0.909) and at 5 minutes (9.5±0.7 vs 9.4±0.9, P=0.527); and recovery time (21.1±6.6 vs 23.4±8.6 minutes, P=0.130).

A single intravenous dexamethasone dosage lowered PONV in children having elective UGIE with severe sedation but had no influence on patient recovery time, postoperative bronchospasm or laryngospasm, or emerging psychosis.