Korean J Anesthesiol.  2017 Oct;70(5):535-541. 10.4097/kjae.2017.70.5.535.

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

• Ismail EA
• Bakri MH
• Abd-Elshafy SK

• KMID: 2395607
• DOI: http://doi.org/10.4097/kjae.2017.70.5.535

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.

Keyword

Cholecystectomy; Dexamethasone; Laparoscopy; Pain; Postoperative nausea and vomiting; Super-hydration

MeSH Terms

Cholecystectomy
Cholecystectomy, Laparoscopic*
Dexamethasone*
Female*
Humans
Incidence
Lactic Acid
Laparoscopy
Meperidine
Ondansetron
Postoperative Nausea and Vomiting*
Dexamethasone
Lactic Acid
Meperidine
Ondansetron