Perioperative dextrose infusion for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy

Abstract

Background and Aims: The effect of intravenous dextrose on the prevention of postoperative nausea and vomiting (PONV) is inconclusive. We aimed to determine the role of perioperative IV dextrose in the prevention of PONV and to analyze factors affecting PONV. Methods: This randomized, double-blind study was conducted in a tertiary care hospital. Two-hundred-fifty-five nondiabetic adults undergoing laparoscopic cholecystectomy were randomized into three groups (n = 85): group NS, group D5, and group D10 to receive perioperatively 250 mL of study fluid infusion (normal saline, dextrose 5%, and dextrose 10%, respectively). Nausea visual analog scale and PONV score, early (0–2 h) and late (2–24 h) PONV and rescue antiemetic treatment were assessed postoperatively. Statistical calculations were done using SPSS 17 version program for Windows. Results: Incidence of early and late PONV was significantly less in Groups D10 (25.9% and 2.4%, respectively) and D5 (43.5% and 17.6%, respectively) compared with Group NS (61.2% and 27.1%, respectively); P < 0.001. Postoperative PONV scores and the need for rescue antiemetics were significantly less in Groups D5 and D10 compared with Group NS; P < 0.05. After study fluid infusion, blood sugar levels (mg%) were significantly higher in patients in Group D10 (242.9 ± 26.2) compared with those who received NS (129.2 ± 10.8) or dextrose 5% (197.1 ± 20.8); P < 0.001. Factors associated with PONV were age, body mass index, female gender, increased anxiety and Apfel score, postoperative opioids, previous PONV, and blood sugar. Conclusions: Perioperative intravenous dextrose 5% (250 mL) can be considered the optimal dose for reducing the incidence and severity of PONV and antiemetic requirement in adults undergoing laparoscopic cholecystectomy.