Comparison of the effect of preoperative administration of Ringer’s solution, normal saline and hypertonic saline 5% on postoperative nausea and vomiting: A randomized, double blinded clinical study

Objectives: Postoperative nausea and vomiting (PONV) are among the most common complications following surgery and anesthesia. Preoperative intravenous fluid therapy is one of the prophylactic methods against PONV. Preoperative administration of hypertonic solutions has already been used for controlling intraoperative hypotension. This study was conducted to assess their efficacy to reduce PONV. Methodology: Ninety patients were enrolled in the study. The patients were allocated randomly, according to a random number table, to three groups. Group A received intravenous saline (15 cc/kg) thirty minutes before induction of anesthesia. Group B received intravenous ringer (15cc/kg) thirty minutes before induction of anesthesia. Group C received hypertonic saline 5% (2cc/kg) half an hour before the induction of anesthesia. Patients were assessed as to the presence of nausea, vomiting and VAS scores in the recovery room, six, twelve and 24 hours after the surgery. Serum sodium level was checked when leaving the recovery room. Data were recorded through questionnaires in data sheets. Results: The analysis indicates that nausea severity in group C (hypertonic saline 5%) was significantly less than other groups. Vomiting frequency distribution was not significantly different among the three groups in the recovery room. The distribution frequency of vomiting six and twelve hours following the surgery was remarkably less in group C. When leaving the recovery room, serum sodium level in group C was significantly higher than other groups. However this level was still within the normal range and none of the patients manifested the signs or symptoms of hypernatremia. Conclusion: This study suggests that hypertonic saline can reduce PONV more significantly than ringer’s solution and normal saline.