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The Combination of Haloperidol, Dexamethasone, and Ondansetron for Prevention of Postoperative Nausea and Vomiting in Laparoscopic Sleeve Gastrectomy: a Randomized Double-Blind Trial

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Abstract

Background

Many patients may experience postoperative nausea and vomiting (PONV) following laparoscopic sleeve gastrectomy (LSG). We evaluated the efficacy of the combination of haloperidol, dexamethasone, and ondansetron for prevention of PONV after LSG.

Methods

Ninety patients were included in this prospective, randomized, double-blinded, three-arm study (group O: ondansetron 8 mg; group DO: dexamethasone 8 mg and ondansetron 8 mg; group HDO: haloperidol 2 mg, dexamethasone 8 mg, and ondansetron). Nausea, vomiting, rescue antiemetic use, morphine consumption, adverse events, and volume of intravenous fluids infused were recorded at regular intervals for 36 h postoperatively.

Results

The incidence of nausea was lower 0–2 h postoperatively in group HDO compared to group O (23.7 versus 56.7 %, p = 0.016) and at 12–24 h postoperatively was lower in group HDO (23.3 %) and group DO (26.7 %) compared to group O (60 %) (p = 0.008 and p = 0.009, respectively). At 0–36 h postoperatively, nausea was lower in group HDO compared to group O (53.3 versus 86.7 %, p = 0.013). Vomiting at 0–36 h postoperatively was lower in group HDO compared to group O (20 versus 53.3 %, p = 0.015). Rescue antiemetic drug and morphine consumption were less used in group HDO compared to group O (p <0.01). The volume of fluids infused in group O was approximately 1 l greater than in group HDO (p = 0.026).

Conclusion

The combination of haloperidol, dexamethasone, and ondansetron reduced PONV and the necessity of rescue antiemetics and also reduced morphine consumption and the volume of fluids infused postoperatively.

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Acknowledgments

We thank BioMed Proofreading for English correction and copy editing of this manuscript.

We also thank Dr. Maria da Dores Gonçalves da Silva, Dr. Marcondes Costa Marques, and Dr. Juliano Blanco Canavarros and Hospital Jardim Cuiabá for the important assistance in this study.

Conflict of Interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery, Medical School, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil

    Márcio Luiz Benevides, Sérgio S de Souza Oliveira & José E de Aguilar-Nascimento

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  1. Márcio Luiz Benevides
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  2. Sérgio S de Souza Oliveira
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  3. José E de Aguilar-Nascimento
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Correspondence to Márcio Luiz Benevides.

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Benevides, M.L., Oliveira, S.S.d.S. & de Aguilar-Nascimento, J.E. The Combination of Haloperidol, Dexamethasone, and Ondansetron for Prevention of Postoperative Nausea and Vomiting in Laparoscopic Sleeve Gastrectomy: a Randomized Double-Blind Trial. OBES SURG 23, 1389–1396 (2013). https://doi.org/10.1007/s11695-013-0923-1

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