A Prospective comparative study of dexmedetomidine and dexamethasone for prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy
Keywords:
Dexmedetomidine, Dexamethasone, Laparoscopic cholecystectomy, Postoperative nausea and vomitingAbstract
Introduction: Postoperative nausea vomiting after general anesthesia is one of the most common causes for patient discomfort and dissatisfaction. Dexmedetomidine is a potent α2-adrenergic agonist that significantly reduces the use of opioids and inhalation anesthetics, reduces postoperative pain, and hence decreases postoperative nausea and vomiting. This study aims to compare the efficacy of a single dose of 1 μg/kg of dexmedetomidine to a single dose of 8 mg dexamethasone to prevent nausea and vomiting.
Methods: This is a prospective randomized comparative study. Eighty-six cases were divided into the Dexmed group receiving dexmedetomidine 1 μg/kg and the Dexona group receiving dexamethasone 8 mg. Incidence of postoperative nausea and vomiting was compared.
Results: Incidence of overall post-operative nausea and vomiting was 23.25% in the dexmedetomidine group in comparison to 27.9% of the dexamethasone group (p =0.624). In the Dexmed group, 27.9% patients required atropine for the treatment of bradycardia (p=0.001) and 20.93% patients developed hypotension (p=0.007). Apfel simplified score was not significantly different between the groups (p=0.056). Postoperative tramadol consumption is lower in the dexmedetomidine group (p=0.024) as only23.25% of patients required additional analgesics in comparison to 46.51% from the Dexona group. Five minutes after extubation, the mean Ramsay sedation score was greater (p=0.01) in the Dexmed group.
Conclusion: Our study showed that the effects of dexmedetomidine are similar to that of dexamethasone in reducing the incidence and severity of postoperative nausea and vomiting following laparoscopic cholecystectomy.
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