Assesment of Pre-Operative effect of Diphenhydramine injection on Post-Operative Pain and Nausea and Vomiting in Ambulatory Patients Surgery (Tympanoplasty)

Abstract

Recent advances in surgical techniques and anesthetic drugs have resulted in a very large proportion of surgical procedures that are currently performed in an ambulatory setting, which increases patient comfort.But despite these advances, postoperative complications such as pain, nausea and vomiting are always present as a clinical problem and affects the length of stay and the quality of recovery.Therefore, medications and anesthesia methods that can reduce postoperative complications in ambulatory surgery are important. Diphenhydramine is an antihistamine with previously demonstrated analgesic and antiemetic properties. However, it is unknown if the beneficial perioperative properties of diphenhydramine can translate to a better quality of postsurgical recovery. The main objective of the current investigation was to evaluate the effect of 25 mg diphenhydramine dose on the quality of recovery after surgery and hospital discharge time. Methods: 100 patients undergoing minor surgery of the ear, nose and throat were randomly divided into two groups (50 patients each). Group 1 received normal saline before induction of anesthesia and group 2 received 25 mg intravenous diphenhydramine. Postoperative pain, nausea and vomiting, the need for ketorolac, and the time of discharge from recovery and hospital were evaluated in both groups. Data were analyzed by SPSS version 20. A P-Value of < 0.05 was considered as statistically significant.

Results: In recovery, the incidence of nausea and vomiting was lower in the diphenhydramine group than in the control group and there was a significant difference between the groups (p = 0.02). Also in this study, the number of patient with moderate and severe pain was higher in the control group, but no significant difference was observed between the groups in this variable (p = 0.76).