Dexamethasone alone versus in combination with intra-operative super-hydration for postoperative nausea and vomiting prophylaxis in female patients undergoing laparoscopic cholecystectomy: a randomized clinical trial.
10.4097/kjae.2017.70.5.535
- Author:
Eman A ISMAIL
1
;
Mohamed H BAKRI
;
Sayed Kaoud ABD-ELSHAFY
Author Information
1. Department of Anesthesia, Assiut University Faculty of Medicine, Assiut, Egypt. sayed_k_72@yahoo.com
- Publication Type:Clinical Trial ; Original Article
- Keywords:
Cholecystectomy;
Dexamethasone;
Laparoscopy;
Pain;
Postoperative nausea and vomiting;
Super-hydration
- MeSH:
Cholecystectomy;
Cholecystectomy, Laparoscopic*;
Dexamethasone*;
Female*;
Humans;
Incidence;
Lactic Acid;
Laparoscopy;
Meperidine;
Ondansetron;
Postoperative Nausea and Vomiting*
- From:Korean Journal of Anesthesiology
2017;70(5):535-541
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Dexamethasone has a prophylactic effect on postoperative nausea and vomiting (PONV) and perioperative hydration is believed to play a role in PONV prophylaxis. This study was performed to examine the combined effects of pre-induction dexamethasone plus super-hydration on PONV and pain following laparoscopic cholecystectomy (LC). METHODS: A total of 100 female patients undergoing LC were enrolled and randomized equally into two groups. Group DF received 5 mg dexamethasone (pre-induction) plus 30 ml/kg Ringer's lactate (intraoperative) and group D received 5 mg dexamethasone (pre-induction) alone. Anesthetic and surgical managements were standardized for all patients. The incidence and severity of PONV, and intra and post-operative analgesic and postoperative antiemetic consumption, were assessed during the first 24 h postoperatively. Post-anesthesia care unit (PACU) stay and aggregated 24 h pain scores were calculated. RESULTS: Group DF had significantly lower PONV than group D (P = 0.03). The number of patients with the lowest PONV score was significantly increased in group DF (P = 0.03). Ondansetron consumption was significantly lower in group DF (P < 0.0001). The mean accumulated 24 h pain scores were significantly lower in group DF compared to group D (P < 0.0001). The time to first analgesic request was significantly longer in group DF than group D (P < 0.0001). In addition, total meperidine consumption during the first postoperative 24 h was significantly lower in group DF than group D (P = 0.002). CONCLUSIONS: In female patients undergoing LC, pre-induction with 5 mg dexamethasone plus intraoperative 30 ml/kg Ringer's lactate solution decreased PONV and pain during the first 24 h postoperatively compared to 5 mg dexamethasone alone.
