Granisetron vs. Granisetron and Dexamethasone on The Reduction of Postoperative Nausea and Vomiting (PONV) After Caesarean Section With Intrathecal Morphine: A Randomised Controlled Trial

Daut, FN Mohd; Seevaunnamtum, SP; Mohamad, NA Nik; Omar, Sanihah Che; Hassan, Wmn Wan

doi:10.1080/11101849.2021.1916860

Cited by 2 publications

(3 citation statements)

References 33 publications

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“…Indeed, dexmedetomidine is a potent α2-adrenoceptor that has been widely used because of its anxiolytic, sedative, analgesic, sympatholytic, and hemodynamic regulatory properties. [ 9 ] Though a plenty of studies support the antiemetic effect of low doses of dexmedetomidine in attenuating postoperative nausea and vomiting,[ 10 16 ] the mechanism is still not fully understood; however, it may be due to the cost-saving of anaesthesia and opioids contributing to postoperative nausea and vomiting, and decreased sympathetic tone may also contribute to the reduction. [ 11 12 19 ]…”

Section: Discussionmentioning

confidence: 99%

“…Medical knowledge researchers spent two decades documenting the effects of dexamethasone in patients undergoing chemotherapy, exploring the anaesthesiologists’ attention to the beneficial role of dexamethasone in attenuating the incidence and severity of postoperative nausea and vomiting. [ 15 16 ] The mechanism of the action of dexamethasone in the attenuation is through its effect on the centre of nausea and vomiting and peripheral impact. [ 4 16 17 ]…”

Section: Introductionmentioning

confidence: 99%

“…[ 15 16 ] The mechanism of the action of dexamethasone in the attenuation is through its effect on the centre of nausea and vomiting and peripheral impact. [ 4 16 17 ]…”

Section: Introductionmentioning

confidence: 99%

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The therapeutic antiemetic and hemodynamic effects of dexmedetomidine, ephedrine, and dexamethasone in combination with midazolam on laparoscopic cholecystectomy patients: A randomised clinical trial

Modir

Dalaei

Pazoki

et al. 2022

J West Afr Coll Surg

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Objective: The objective was to compare the hemodynamic and antiemetic effects of the combination of midazolam with ephedrine, dexamethasone, and dexmedetomidine in laparoscopic cholecystectomy surgical patients. Materials and Methods: This randomised, parallel-group, double-blind clinical trial was conducted by enrollment of 96 patients who were referred for laparoscopic cholecystectomy. Patients assigned into three equal-sized intervention arms having received anaesthesia induction with midazolam-ephedrine, midazolam-dexamethasone, and midazolam-dexmedetomidine using a block randomisation method. Frequency and severity of nausea and vomiting were observed from recovery to 24 h later, adverse events, and sedation on Ramsay sedation scale at recovery, 1, 2, and 4 h postoperatively. Data were recorded and analysed at a significance level lower than 0.05 in SPSS software. Results: The clinical parameters including mean blood pressure at all times and heart rate in 60–90 min were lower in the dexmedetomidine group when compared with other groups. The lowest severity of postsurgery nausea occurrence was observed in the midazolam-dexamethasone group and those receiving midazolam-dexmedetomidine from 4 to 24 h. In addition, vomiting scores were lower throughout recovery up to postoperative 4 h in the dexamethasone and dexmedetomidine groups (all P < 0.05). The highest sedation score was observed in the dexmedetomidine group during recovery up to 2 h ( P = 0.001), reflecting a more clinically superior effect than dexamethasone ( P = 0.01). Conclusions: A positive implication of dexmedetomidine was observed in attenuating postoperative nausea and vomiting and potentiating sedation. Nevertheless, it is providing a drop in the blood pressure and heart rate. Lending support to the potent adjuvant efficacy of dexamethasone following dexmedetomidine, consequently, a hypothesis can be put forward, stating that the dexmedetomidine and dexamethasone as adjuvants to midazolam are expected to bring the advantages of avoiding the adverse events and improving postoperative sedation.

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