Korean J Anesthesiol.  2019 Feb;72(1):47-52. 10.4097/kja.d.18.00132.

Comparison of intraperitoneal versus intravenous dexamethasone on postoperative nausea and vomiting after gynecological laparoscopy: a randomized clinical trial

• Ismail EA
• Abo Elfadl GM
• Bahloul M

• KMID: 2438621
• DOI: http://doi.org/10.4097/kja.d.18.00132

Abstract

BACKGROUND
Postoperative nausea and vomiting (PONV) is a common complication following laparascopic surgery. This study compared the effect of intraperitoneal versus intravenous dexamethasone for reducing PONV after gynecological laparoscopic surgeries.
METHODS
Eighty adult female patients, American Society of Anesthesiologists physical status I-II, scheduled for gynecological laparoscopic surgery were randomized to receive 8 mg dexamethasone intravenously (IV) (n = 40) or intraperitoneally (IP) (n = 40). The primary outcome was the PONV incidence during the first 24 h after laparoscopy. Secondary outcomes included visual analogue scale (VAS) pain scores, total rescue analgesic consumption during the first 24 h postoperatively, the need for rescue antiemetic drugs, and the incidence of complications that may accompany these medications.
RESULTS
Eleven women (27.5%) in the IV group, versus only 3 (7.5%) women in the IP group, experienced nausea during the first 24 h postlaparoscopy (P = 0.037). However, 5 patients (12.5%) in the IV group, versus only 2 patients (5.0%) in the IP group, experienced vomiting (P = 0.424). No statistically significant differences were seen in the severity of nausea or the need for rescue antiemetics. The IV group had a higher rate of side-effects than the IP group (27.5% vs. 7.5%, P = 0.037). Headache and dizziness were common side effects in the IV dexamethasone group. The groups did not differ significantly in terms of mean VAS score for pain and total meperidine consumption during the first 24 h postoperatively.
CONCLUSIONS
Intraperitoneal dexamethasone at a dose of 8 mg at the end of gynecological laparoscopy reduces the incidence of postoperative nausea.

Keyword

Dexamethasone; Gynecology; Intraperitoneal; Laparoscopy; Nausea; Vomiting

MeSH Terms

Adult
Antiemetics
Dexamethasone*
Dizziness
Female
Gynecology
Headache
Humans
Incidence
Laparoscopy*
Meperidine
Nausea
Postoperative Nausea and Vomiting*
Vomiting
Antiemetics
Dexamethasone
Meperidine