Abstract
The aim of this study was to determine the effect of dexamethasone and ketolgan on postoperative nausea and vomiting and to evaluate risk factors for postoperative nausea and vomiting. A prospective, double-blind, randomized clinical study was carried out. One hundred fifty-three ASA I-II women undergoing laparoscopic gynecologic operations were randomized into three groups: dexamethasone group (n=51), ketolgan group (n=51), and control group (n=51). Patients in the dexamethasone group were given 4 mg of dexamethasone intravenously before the induction of general anesthesia, the ketolgan group received 30-mg ketolgan intravenously, and control group did not receive any medication. The incidence and severity of postoperative nausea and vomiting were registered 24 hours after the surgery. The incidence of postoperative nausea and vomiting in the dexamethasone group was 13.8%; in the ketolgan group, 37.3%, and in the control group, 58.9% (P=0.026). Patients with a history of migraine suffered from postoperative nausea and vomiting in 70.3% of cases and migraine-free patients in 25.8% of cases (P=0.015). Opioids for postoperative analgesia increased the incidence of postoperative nausea and vomiting as compared with nonsteroidal anti-inflammatory drugs (P=0.00002). Preoperative medication with dexamethasone significantly reduces the incidence of postoperative nausea and vomiting. Avoidance of opioids for postoperative analgesia reduces the incidence of postoperative nausea and vomiting. Migraine and motion sickness are independent risk factors for postoperative nausea and vomiting.
Highlights
Postoperative nausea and vomiting (PONV) is one of the most common complications in the early postoperative period associated with surgery performed under general anesthesia
Preoperative medication with dexamethasone signifi cantly reduces the incidence of postoperative nausea and vomiting
Avoidance of opioids for postoperative analgesia reduces the incidence of postoperative nausea and vomiting
Summary
Postoperative nausea and vomiting (PONV) is one of the most common complications in the early postoperative period associated with surgery performed under general anesthesia. Most of them admit to fear PONV even more than pain or other postoperative complications. Literature data show that the incidence of PONV is approximately 25–30% with specific surgeries having much higher incidence of up to 70%–80% (1). It is documented that gynecologic surgery (3–5), especially laparoscopic surgery, related to increased intra-abdominal pressure is often followed by PONV (2). The incidence of PONV is 2- to 4-fold higher in female population (2). Even though PONV usually is not a life-threatening postoperative complication (6), Material and methods One hundred fifty-three women classified as ASA physical status I–II, undergoing laparoscopic gynecologic surgery were enrolled in our pro-
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