Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 0 0 2026 06 13 1570 1570 Hamidreza Shetabi Anesthesiology and Critical Care Research Center, Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran. Amir Shafa Anesthesiology and Critical Care Research Center, Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran. Mehrdad Norouzi Anesthesiology and Critical Care Research Center, Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran. Zahra Rahimi Anesthesiology and Critical Care Research Center, Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran. Ali-Mohammad Bameri Anesthesiology and Critical Care Research Center, General Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. 2026 02 13 2026 04 23 Background: After laparoscopic surgery, children often experience postoperative nausea and vomiting (PONV), a common issue that can affect up to 70% of patients if no preventive steps are taken. While dexamethasone administered through an IV has been thoroughly studied for preventing PONV, there’s much less information available about using it nasally. This study set out to explore how effective intranasal dexamethasone is and how long its benefits last in reducing PONV in pediatric patients. Methods: In our study, we split 116 children aged 2 to 15 years, all preparing for laparoscopic surgery, into two groups after anesthesia started: one group (IND) received intranasal dexamethasone at a dose of 0.2 mg per kg, while the other group (INS) was given normal saline as a placebo. The main focus was on PONV rates over the initial 24 hours postoperatively. Results: In the first 24 hours, PONV hit 24.1% in the dexamethasone arm compared to 46.6% in saline (odds ratio 0.38, 95% CI from 0.20 to 0.70; p=0.002). The onset of first nausea or vomiting came later, and fewer kids needed backup antiemetics (21% vs. 40%). Post-anesthesia care unit (PACU) time was cut by about 18 minutes on average in the IND group (95% CrI -30 to -7). Parents gave higher marks for satisfaction, with 81% rating 4 or above versus 55% in INS. Conclusion: Intranasal dexamethasone reduces nausea and vomiting after laparoscopic surgery in children within the first 24 hours. Intranasal dexamethasone administration is a useful option for preventing PONV in children. https://aacc.tums.ac.ir/index.php/aacc/article/view/1570