Microvascular reconstruction surgery operated for more than 5 hours duration under general anaesthesia with endotracheal intubation is challenging to the anaesthesiologist. Post op cough, hoarseness and sorethroat are side effects, causing dissatisfaction to the patient and can prolong recovery time.

Materials and Methods: Our prospective study of sixty patients was randomized into two groups of thirty each. Group D patients received iv dexamethasone 8 mg and group N patients received  normal saline 2 ml after intubation. Postop cough, sore throat and hoarseness will be noted immediate after extubation, 30 minutes, one hour and twenty fours post extubation.

Results: The incidence of postop cough was lower in dexamethasone group patients than normal saline group patients at extubation (but not statistically significant with p=0.166). Dexamethasone group patients also had lower postop hoareseness score at 60 minutes post extubation (p= 0.181).

Conclusion: Administration of intravenous dexamethasone can reduce the incidence of postop cough in patients undergoing microvascular reconstruction surgery.