Korean J Anesthesiol.  2015 Jun;68(3):254-260. 10.4097/kjae.2015.68.3.254.

Comparison of dexmedetomidine and dexamethasone for prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy

• Bakri MH
• Ismail EA
• Ibrahim A

• KMID: 2148690
• DOI: http://doi.org/10.4097/kjae.2015.68.3.254

Abstract

BACKGROUND
Postoperative nausea and vomiting (PONV) are common following laparoscopic cholecystectomy (LC). Dexamethasone has been reported to reduce PONV. However, there is insufficient evidence regarding the effect of dexmedetomidine in decreasing PONV. This study was designed to compare the effects of a single dose of dexmedetomidine to dexamethasone for reducing PONV after LC.
METHODS
Eighty-six adult patients scheduled for LC were randomized to receive either single dose 1 microg/kg of dexmedetomidine (Dexmed group, N = 43) or 8 mg dexamethasone (Dexa group, N = 43) before skin incision. During the first 24 h postoperatively, the incidence and severity of PONV were assessed. Pain and sedation scores were assessed on arrival in the recovery room and early postoperatively. Analgesic and antiemetic consumption during the 24 h after surgery were calculated. Intra-operative and postoperative hemodynamics were recorded.
RESULTS
Twenty-one percent of the patients in the Dexmed group developed PONV compared to 28% in the Dexa group (P = 0.6). Severity of PONV was similar between the two groups (P = 0.07). Early postoperatively, pain severity was significantly lower in the Dexmed group, but sedation scores were significantly higher. The first analgesic request was significantly delayed in the Dexmed group (P = 0.02). The total amounts of intraoperative fentanyl and postoperative tramadol administered were significantly lower in the Dexmed group. No difference in ondansetron was noted between the two groups. Mean arterial pressure and heart rate were significantly lower in the Dexmed group after administration of dexmedetomidine. No major side effects were reported.
CONCLUSIONS
Dexmedetomidine reduces the incidence and severity of PONV, similar to dexamethasone. It is superior to dexamethasone in reducing postoperative pain and total analgesic consumption during the first 24 h after LC.

Keyword

Cholecystectomy; Dexamethasone; Dexmedetomidine; Laparoscopy; Postoperative nausea and vomiting

MeSH Terms

Adult
Arterial Pressure
Cholecystectomy
Cholecystectomy, Laparoscopic*
Dexamethasone*
Dexmedetomidine*
Fentanyl
Heart Rate
Hemodynamics
Humans
Incidence
Laparoscopy
Ondansetron
Pain, Postoperative
Postoperative Nausea and Vomiting*
Recovery Room
Skin
Tramadol
Dexamethasone
Dexmedetomidine
Fentanyl
Ondansetron
Tramadol