Randomized clinical trial of the effect of preoperative dexamethasone on nausea and vomiting after laparoscopic cholecystectomy

Feo, Carlo V.; Sortini, Davide; Ragazzi, Riccardo; Palma, Massimiliano De; Liboni, A

doi:10.1002/bjs.5252

Cited by 71 publications

(70 citation statements)

References 35 publications

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“…Postoperative nausea and vomiting has been reported with an incidence of 53-72 % after laparoscopic cholecystectomy [22]. However its incidence tends to decrease during the early postoperative recovery [23,24].…”

Section: Discussionmentioning

confidence: 99%

Drain after elective laparoscopic cholecystectomy. A randomized multicentre controlled trial

Picchio¹,

Angelis

Zazza³

et al. 2012

Surg Endosc

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Background Routine drainage after laparoscopic cholecystectomy is still debatable. The present study was designed to assess the role of drains in laparoscopic cholecystectomy performed for nonacutely inflamed gallbladder. Methods After laparoscopic gallbladder removal, 53 patients were randomized to have a suction drain positioned in the subhepatic space and 53 patients to have a sham drain. The primary outcome measure was the presence of subhepatic fluid collection at abdominal ultrasonography, performed 24 h after surgery. Secondary outcome measures were postoperative abdominal and shoulder tip pain, use of analgesics, nausea, vomiting, and morbidity. Results Subhepatic fluid collection was not found in 45 patients (84.9 %) in group A and in 46 patients (86.8 %) in group B (difference 1.9 (95 % confidence interval -11.37 to 15.17; P = 0.998). No significant difference in visual analogue scale scores with respect to abdominal and shoulder pain, use of parenteral ketorolac, nausea, and vomiting were found in either group. Two (1.9 %) significant hemorrhagic events occurred postoperatively. Wound infection was observed in three patients (5.7 %) in group A and two patients (3.8 %) in group B (difference 1.9 (95 % CI -6.19 to 9.99; P = 0.997). Conclusions The present study was unable to prove that the drain was useful in elective, uncomplicated LC.

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Section: Discussionmentioning

confidence: 99%

Drain after elective laparoscopic cholecystectomy. A randomized multicentre controlled trial

Picchio¹,

Angelis

Zazza³

et al. 2012

Surg Endosc

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“…In thyroid patients, oedema and inflammation around the neck tissues may sustain evoked parasympathetic impulses through vagus, recurrent laryngeal and glossopharyngeal nerve to the vomiting centre. Dexamethasone reduce tissue inflammation and reduce the ascending parasympathetic impulses to the vomiting centre [16]. Wide range of single dose is used (8-32mg), most commonly 8mg, but optimal dose is yet to be defined.…”

Section: Time Of Analgesiamentioning

confidence: 99%

“…Jaleel F, Basanth Bhattarai and Ming Shan Chen in their studies have shown that dexamethasone have shown good prophylactic effect for PONV when given one hour prior to surgery or beginning of surgery [17][18][19]. Three randomized controlled studies on timing of dexamethasone have demonstrated that no significant statistical difference between timing of giving in beginning or end of surgery [16,17,20]. Hence, we administered dexamethasone at the end of surgery.…”

Section: Time Of Analgesiamentioning

confidence: 99%

Comparison of Efficacy of Clonidine versus Ondansetron for Prevention of Nausea and Vomiting Post Thyroidectomy: A Double Blind Randomized Controlled Trial

Shailaja

Hilda

2015

JCDR

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“…PONV can lead to sweating, tachycardia, abdominal pain, prolonged recovery duration and increased risk of aspiration (3). The etiology of PONV is not still known well, but it is probably a multifactorial phenomenon (4,5). Gas entrance into the abdominal cavity during laparoscopy can cause increased pressure of peritoneal cavity which may lead to PONV (3).…”

Section: Introductionmentioning

confidence: 99%

“…Prolonged entrance of CO 2 leads to pneumo peritoneum, peritoneal distention and diaphragmatic stimulation. Intra-abdominal manipulation is one of the causes of PONV (4,5). Different medications have been evaluated in PONV prophylaxis and patient satisfaction after cholecystectomy (1-7).…”

Section: Introductionmentioning

confidence: 99%

Granisetron Versus Dexamethasone in Prophylaxis of Nausea and Vomiting After Laparoscopic Cholecystectomy

Hessami

Yari²

2012

anesthpain

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Dexamethasone is a low price corticosteroid which has anti-inflammatory effects. This article help us to find a cost effective drug for prophylaxis of PONV.Background: Post-operative nausea and vomiting (PONV) is one of the common problems after laparoscopic cholecystectomy. Objectives: The current study aimed to compare Dexamethasone effect with that of Granisetron in prevention of PONV. Patients and Methods: In the current study 104 patients aged 20-60 with ASA class I or II who were candidates for laparoscopic cholecystectomy were included in the study. Patients were randomly divided into two groups of A and B. 15 minutes before anesthesia induction, in group a patient's 3 mg Granisetron and in group B patients 8 mg Dexamethasone was intravenously injected. Then both groups underwent general anesthesia with similar medications. After operation the prevalence of nausea and vomiting was assessed at three time intervals (0-6 hours, 6-12 hours and 12-24 hours after consciousness). SPSS software version 16 was employed to analyze data. T test, chi-square test and Fischer exact test were performed level of significance was P < 0.05. Results: There was no significant difference between age, gender proportion, weight, height, and body mass index (BMI) of patients in the two groups. In Dexamethasone group, seven patients experienced nausea and three patients had vomiting, and in Granisetron group, five patients experienced nausea and three patients had vomiting after consciousness. Statistical analysis indicated no significant difference between the two groups in this regard. Conclusions: Intravenous injection of 8 mg Dexamethasone or 3 mg Granisetron before anesthesia induction had similar effects in prophylaxis of nausea and vomiting after laparoscopic cholecystectomy.

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Randomized clinical trial of the effect of preoperative dexamethasone on nausea and vomiting after laparoscopic cholecystectomy

Abstract: Preoperative dexamethasone reduces postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy, with no side-effects, and may be recommended for routine use.

Cited by 71 publications

References 35 publications

Drain after elective laparoscopic cholecystectomy. A randomized multicentre controlled trial

Drain after elective laparoscopic cholecystectomy. A randomized multicentre controlled trial

Comparison of Efficacy of Clonidine versus Ondansetron for Prevention of Nausea and Vomiting Post Thyroidectomy: A Double Blind Randomized Controlled Trial

Granisetron Versus Dexamethasone in Prophylaxis of Nausea and Vomiting After Laparoscopic Cholecystectomy

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