Prophylactic Anti-Emetic Effect of Dexamethasone and Metoclopramide on the Nausea and Vomiting Induced by Laparoscopic Cholecystectomy: A Randomized, Double Blind, Placebo-Controlled Trial

AUTHORS

Ali Reza Khalaj 1 , Seyed Rohollah Miri 2 , * , Mojdeh Porlashkari 3 , Amin Mohammadi 4

1 Department of Surgery, Shahed University, Tehran, IR Iran

2 Department of Surgery, Tehran University of Medical Sciences, Tehran, IR Iran, [email protected]

3 Department of Pathology, Tehran University of Medical Sciences, Tehran, IR Iran

4 Tehran University of Medical Sciences, Tehran, IR Iran

How to Cite: Reza Khalaj A, Rohollah Miri S, Porlashkari M, Mohammadi A. Prophylactic Anti-Emetic Effect of Dexamethasone and Metoclopramide on the Nausea and Vomiting Induced by Laparoscopic Cholecystectomy: A Randomized, Double Blind, Placebo-Controlled Trial, J Minim Invasive Surg Sci. Online ahead of Print ; 2(3):18-22.

ARTICLE INFORMATION

Journal of Minimally Invasive Surgical Sciences: 2 (3); 18-22
Published Online: June 29, 2013
Article Type: Research Article
Received: December 2, 2012
Accepted: January 25, 2013
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Abstract

Background: Postoperative nausea and vomiting (PONV) is an unpleasant, distressing and frequent adverse effect after general anesthesia and surgery which has a high incidence in patients undergoing laparoscopic cholecystectomy. While none of the currently available antiemetic drugs are fully effective in all patients, it has been reported that dexamethasone is effective against emesis in patients undergoing general anesthesia.

Objectives: This study evaluates the prophylactic anti-emetic effect of dexamethasone in comparison with metoclopramide and placebo for the prevention of post-operative nausea and vomiting in patients undergoing elective laparoscopic cholecystectomy.

Patients and Methods: In Mostafa Khomeini hospital, a teaching hospital of Shahed University, Tehran, Iran, a randomized, double-blind and placebo-controlled study on 161 patients undergoing general anesthesia for elective laparoscopic cholecystectomy was run.One hundred sixty one patients (124 females and 37 males) requiring general anesthesia for laparoscopic cholecystectomy were studied. The dexamethasone group (n = 53) received dexamethasone 8mg IV, the metoclopramide group (n = 55) received metoclopramide 10mg IV and the placebo group (n = 53) received 2ml saline IV at the induction of anesthesia.

Results: In the current study, 26.4 %, 32.7 % and 52.8 % of patients reported vomiting in the dexamethasone, metoclopramide and placebo group (P < 0.001), respectively. The total incidence of nausea and vomiting also reduced to 30.2 % with dexamethasone in comparison with 49.1 % in metoclopramide group and 58.5 % in placebo group. (P < 0.001)

Conclusions: Dexamethasone 8mg is a better anti-emetic agent than metoclopramide for the prevention of post-operative nausea and vomiting after laparoscopic cholecystectomy.

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© 2013, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
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