Comparing the Effect of Dexamethasone, Normal Saline, and Metoclopramide on Prevention of Postoperative Nausea, Vomiting and Pain in Patient Undergoing Laparoscopic Cholecystectomy or Open Appendectomy: A Randomized Clinical Trial

Abstract

BACKGROUND: Post-operative nausea and vomiting (PONV) and pain are a common complications of adult patients undergoing anesthesia, but the incidence of these complications in patients go through laparoscopic cholecystectomy or open appendectomy is unknown.
 AIM: We conduct this study for comparing the effect of dexamethasone administration with normal saline and with metoclopramide for reducing these undesirable effects.
 DESIGN: This was a three-armed, parallel-group, double-blind, and randomized controlled clinical trial.
 METHODS: Seventy-two patients of both genders underwent elective surgeries (laparoscopic cholecystectomy or open appendectomy), randomly assigned to three groups: A dexamethasone-treated (8 mg) group (Group 1) (n = 24), normal saline-treated (100 ml) group (Group 2) (n = 24), and metoclopramide-treated (10 mg) group (Group 3) (n = 24). All nausea, vomiting, and pain episodes were recorded during 24 h after anesthesia in three time periods: 0–4, 4–12, and 12–24 h post-anesthesia.
 Results: Nausea and vomiting grading scale shows no significant difference when compare dexamethasone (Group 1) with normal saline (Group 2), significant difference when compare dexamethasone (Group 1) with metoclopramide (Group 3), and also significant difference when compare normal saline (Group 2) with metoclopramide (Group 3). Group 1 showed a lower pain score (p < 0.01 and p < 0.0001) compared with pain score recorded by patients of Groups 2 and 3, respectively. Besides that, Group 2 also showed a lower pain score (p < 0.0001) compared with pain score recorded by Group 3 patients.
 CONCLUSION: Dexamethasone has unimportant effect when compare with normal saline, more effectiveness than metoclopramide in reducing PONV. However, dexamethasone more effective in reducing pain when comparing with normal saline and metoclopramide for patients they underwent laparoscopic cholecystectomy or open appendectomy surgery under general anesthesia.

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