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

Khalaj, Ali; Miri, Seyed Rohollah; Porlashkari, Mojdeh; Mohammadi, Amin

doi:10.5812/jmiss.9434

Cited by 6 publications

(5 citation statements)

References 25 publications

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“…This study was conducted to evaluate the efficacy of ginger for PONV prevention in patients undergoing laparoscopic cholecystectomy, and the main findings revealed that this agent seems to be clinically and sometimes, statistically effective. PONV is one of the most annoying complications following general anesthesia, mainly in laparoscopic surgery ( 28 , 29 ). Also in our study, according to the time of data recording, the incidence of PONV was somehow similar to the previous studies, around 20–70% ( 1 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of oral ginger on prevention of nausea and vomiting after laparoscopic cholecystectomy: a double-blind, randomized, placebo-controlled trial

Bameshki¹,

Namaiee²,

Jangjoo³

et al. 2018

Electron Physician

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BackgroundPostoperative nausea and vomiting (PONV) are among the most frequent complications following laparoscopic cholecystectomy. Recently, some studies have shown ginger, as an herbal medicine, to be effective and safe in PONV prevention; however, there is no evidence of its efficacy in the Iranian population.ObjectiveThe aim of this study was to determine the effect of oral ginger on PONV prevention after laparoscopic cholecystectomy.MethodsThis double-blind, randomized, placebo-controlled clinical trial was performed on women who were undergoing laparoscopic cholecystectomy in Imam Raza Hospital, Mashhad, Iran between April and November, 2016. Patients were divided randomly into two groups of G) intervention group (n=75, received 2 capsules containing 250 mg ginger) and P) placebo group (n=75, received 2 placebo capsules) one hour before surgery. Nausea severity and vomiting frequency were evaluated at 2, 4, 6, and 12 hours after the operation. Data analysis was done by SPSS version 16.0 software with Chi-square test, Independent-sample-t-test, repeated measure ANOVA and Mann–Whitney U test.ResultsThe two groups were homogenous in terms of age, gender and surgery duration. The severity of nausea was lower in the ginger group at the 2, 4, 6, and 12 hours after the operation; however, these differences were statically significant only at 2 (p=0.034) and 12 hours (p=0.043). Although the incidence of vomiting was higher in the placebo group in the 2nd and 12th hours after surgery, the number of vomiting episodes in 2, 4, 6 and 12 hours after surgery was statistically similar in the two groups (p>0.05). The nausea severity was significantly changed during 12 hours of study in both groups (p=0.001), however the nausea severity was always lower in the ginger group (p=0.078).ConclusionThis study demonstrated that 500mg oral ginger one hour before surgery in women who were undergoing laparoscopic cholecystectomy is effective in decreasing severity of PONV.Trial registrationThe trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2016122222218N2.FundingThe study was financially supported by Deputy of Research of Mashhad University of Medical Sciences.

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Section: Discussionmentioning

confidence: 99%

Effect of oral ginger on prevention of nausea and vomiting after laparoscopic cholecystectomy: a double-blind, randomized, placebo-controlled trial

Bameshki¹,

Namaiee²,

Jangjoo³

et al. 2018

Electron Physician

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“…While long- term consumption of steroids is associated with some side effects such as increased risk of wound infection, delayed wound healing, adrenal suppression and glucose intolerance, their single-dose administration is safe ( 11 , 13 ). Performed meta- analyses about effect of dexamethasone on postoperative pain revealed that more dexamethasone (base on mg/kg) is accompanied with higher effectiveness.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, dexamethasone should be useful in lowering pain, nausea and vomitting, due to its potential anti- inflammatory effect. Dexamethasone is the most powerful anti-inflammatory drug with a long half- life; and its administration is considered safe for periods shorter than two weeks even in amounts above physiological doses ( 10 , 11 ).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Single-Dose Administration of Dexamethasone on Postoperative Pain in Patients Undergoing Laparoscopic Cholecystectomy

et al. 2014

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Background:Postoperative pain is considered as a reason of patient’s delay in discharge and disability aggravation. Therefore, multimodal approaches have been suggested in order to mitigate pain and decrease postoperative side effects.Objectives:The aim of this study was to evaluate analgesic effect of a single dose injection of dexamethasone on reducing postoperative pain in laparoscopic cholecystectomy.Patients and Methods:In this double-blind, prospective study, 122 patients aged 18-60 years old, whom were selected for laparoscopic cholecystectomy, were classified into two case and control groups, and 61 patients were included in each group. The case (D) group underwent general anesthesia and a single- dose intravenous injection of dexamethasone. The Control (C) group received general anesthesia and intravenous injection of normal saline. Total dose of consumed meperidine and pain intensity during first 24 hours were evaluated in both groups.Results:No significant difference existed between two groups regarding age, sex, weight and operation time. Pain intensity in group D was significantly less than group C (P < 0.01) after two, six and 12 hoursof surgery. No significant difference existed in pain intensity between two groups at the beginning of and 24 hours after the surgery (P > 0.05). Meperidine consumption in group D was significantly less than group C (P < 0.05).Conclusions:Findings of present study showed that single dose of intravenous dexamethasone, led to less pain intensity and amounts of meperidine consumption, in comparison with placebo.

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“…Several studies have explored its use in preventing PONV with favorable outcomes. However, dexamethasone administration's optimal dosage and timing remain subjects of ongoing investigation (Khalaj et al, 2013). This study aims to contribute to the body of evidence by assessing the incidence of post-operative nausea and vomiting in patients undergoing laparoscopic cholecystectomy after receiving a single preoperative dose of dexamethasone.…”

Section: Introductionmentioning

confidence: 99%

Iincidence of Post-Operative Nausea and Vomiting in Laparoscopic Cholecystectomy With a Single Dose of Preoperative Dexamethasone

NAEEMI

2023

Biol Clin Sci Res J

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and vomiting (PONV). Dexamethasone, a synthetic glucocorticoid with potent anti-inflammatory, immune-modulating, analgesic, and anti-emetic effects, effectively reduces the incidence of PONV after laparoscopic cholecystectomy. In this double-blind, placebo-controlled study, we aimed to investigate the efficacy of a single 8 mg dose of dexamethasone in preventing PONV in patients undergoing laparoscopic cholecystectomy. Sixty patients were randomized into two groups: group A, who received an 8 mg dexamethasone injection in a 2-ml preparation, and group B, who received normal saline during induction. Both groups received standardized anesthesia. Post-operatively, the incidence of nausea and vomiting was observed in both groups. Our study's findings indicate that no substantial variances were observed between the two cohorts in terms of medical or demographic factors. However, a lower proportion of patients in group A exhibited post-operative nausea and vomiting (PONV), while group B had a higher demand for anti-emetic medications to alleviate PONV symptoms. Thus, we can infer that administering a solitary dose of dexamethasone before laparoscopic cholecystectomy can reduce the risk of post-operative complications in patients.

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

Cited by 6 publications

References 25 publications

Effect of oral ginger on prevention of nausea and vomiting after laparoscopic cholecystectomy: a double-blind, randomized, placebo-controlled trial

Effect of oral ginger on prevention of nausea and vomiting after laparoscopic cholecystectomy: a double-blind, randomized, placebo-controlled trial

The Effect of Single-Dose Administration of Dexamethasone on Postoperative Pain in Patients Undergoing Laparoscopic Cholecystectomy

Iincidence of Post-Operative Nausea and Vomiting in Laparoscopic Cholecystectomy With a Single Dose of Preoperative Dexamethasone

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