Background: Postoperative nausea and vomiting (PONV) are major adverse
consequences following laparoscopic cholecystectomy. Several drugs have been used
to combat its occurrence.
Objective: This study aimed to show the efficacy of the intraperitoneal route and
compare different antiemetic effects of dexamethasone, dexmedetomidine, and their
combination on PONV after laparoscopic cholecystectomy under general anesthesia
in a tertiary care hospital.
Design: Prospective randomized triple-blind study.
Setting: The trial was conducted at Benha University Hospitals. The trial was done
from August 2023 to April 2024.
Patients: Two hundred and forty patients aged 20–50 years, Apfel Score 1, the
American Society of Anesthesiologists (ASA) physical status Classification I or II who
underwent laparoscopic cholecystectomy. Exclusion criteria were a history of
psychotic illnesses, Parkinson’s disease, motion disorder, and a history of
chemotherapy.
Interventions: Patients were randomized equally into four groups. Group I (control
group) received 20 mL normal saline, Group II (dexamethasone group) received 8 mg
dexamethasone, Group III (dexmedetomidine group) received dexmedetomidine
1mic/kg, and Group IV (combination group) received the combination of both
dexamethasone (8 mg) + dexmedetomidine (1mic/kg). The medications were diluted
in 20 mL normal saline.
Main outcome measures: The incidence of PONV encountered by patients in the first
24 h following surgery was recorded.
Results: Nausea was reported in 26 (43.33%), 10 (16.67%), 11 (18.33%), and 6
(10%) in Groups I, II, III, and IV, respectively. Vomiting was observed in 25 (41.67%),
11 (18.33%), 10 (16.67%), and five (8.33%) in Groups I, II, III, and IV, respectively.
Antiemetic medication was required for 24 (40%), 11 (18.33%), 12 (20%), and eight
(13.33%) in Groups I, II, III, and IV, respectively. Nausea, vomiting, and antiemetics
requirements differed significantly among the four groups ( value < 0.05).
Conclusions: Intraperitoneal administration of dexamethasone and
dexmedetomidine either alone or in combination decreased the incidence of PONV
among patients scheduled for laparoscopic cholecystectomy. |
