Efficacy of dexamethasone in prevention of postoperative nausea and vomiting in laparoscopic cholecystectomy.

Abstract

Objective: To evaluate the efficacy of intravenous dexamethasone in comparison with control group for the prevention of po3stoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy. Study Design: Randomized controlled study. Setting: Department of Surgery, Dr. Akbar Niazi Teaching Hospital, Islamabad, Pakistan. Period: 1st November 2022 to 31st April 2023. Material & Methods: A total of 120 patients of prospective laparoscopic cholecystectomy from both genders in ages between 18-60 years were randomized into two equal groups A and B. Group A subjects were administered with 4 mg IV dexamethasone preoperatively while group B patients were control subjects. The primary outcome was set as the reduced PONV after surgery. It was assessed through VAS scores and recorded at different time intervals. The final outcome was measured at 24th hour. Rescue antiemetic was administered whenever VAS score became > 5. Results: At 24 hours after surgery, VAS score was 0.57 ± 1.42 SD in group A and in group B it was 1.67 ± 2.10 SD (p=0.001). Efficacy of treatment (no PONV up to 24 hours) was present in 81.7% patients in group A (dexamethasone) and in 56.7% of patients in group B (control). The difference was statistically significant (P=0.003). Conclusion: Preoperative intravenous administration of dexamethasone was found effective in controlling PONV in patients undergoing laparoscopic cholecystectomy. Moreover, prophylactic dexamethasone administration also resulted in lesser consumption of rescue antiemetics when compared with controlled group.