Postoperative vomiting in patients after laparoscopic surgery

Abstract

BACKGROUND: Postoperative nausea and vomiting (PONV) is common after anaesthesia and surgery. We decided to evaluate metoclopramide, dexamethasone, and their combination in preventing PONV in patients under going laparoscopic surgery. METHOD: 396 patients were studied. Four groups were created: group received metoclopramide postoperatively; group 2 received dexamethasone following anaesthesia; and group 3 received dexamethasone following anaesthesia and metoclopramide before end of anaesthesia. Results were compared to group without anti-emetic. PONV incidence, basal and active mean visual analogue pain scores, time to first analgesia request, side effects, and well-being score were recorded at first 24 h postoperatively. RESULTS: Literature total incidence of PONV was 60% in control group de void of anti-emetic but 45% of PONV was seen in Group 1 with metoclopramide, Group 2 -23% with dexamethasone, and Group 3-12% with the combination of dexamethasone and metoclopramide. Anti-emetic rescue was not required in dexamethasone plus metoclopramide group or group with only dexamethasone, compared with four patients in the metoclopramide group and six patients in the control group. CONCLUSION: Dexamethasone or dexamethasone + metoclopramide combination was more effective in preventing PONV than metoclopramide or lack of anti-emetic. Scripta Scientifica Medica 2011;V.43(1):27-30