Surgical Endoscopy

, Volume 21, Issue 4, pp 607–612

Comparison of dexamethasone, metoclopramide, and their combination in the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy

  • V. Nesek-Adam
  • E. Grizelj-Stojčić
  • Ž. Rašić
  • Z. Čala
  • V. Mršić
  • A. Smiljanić
Article

DOI: 10.1007/s00464-006-9122-7

Cite this article as:
Nesek-Adam, V., Grizelj-Stojčić, E., Rašić, Ž. et al. Surg Endosc (2007) 21: 607. doi:10.1007/s00464-006-9122-7

Abstract

Background

Postoperative nausea and vomiting (PONV) are one of the most common complaints following anesthesia and surgery. This study was designed to evaluate the efficacy of dexamethasone, metoclopramide, and their combination to prevent PONV in patients undergoing laparoscopic cholecystectomy.

Methods

A total of 160 ASA physical status I and II patients were included in this randomized, double blind, placebo-controlled study. Patients were randomly assigned to 4 groups (n = 40 each): group 1 consisting of control patients administered 0.9% NaCl; group 2 patients received metoclopramide 10 mg just before the end of anesthesia; group 3 patients received dexamethasone 8 mg after the induction of anesthesia; and group 4 patients received dexamethasone 8 mg after the induction of anesthesia and metoclopramide 10 mg before the end of anesthesia. The incidence of PONV, mean visual analog pain scores at rest and on movement, time to the first request for analgesia, side effects, and well-being score were recorded during the first 24 h postoperatively.

Results

Data were analyzed using one-way analysis of variance (ANOVA) and the χ2 test, with p < 0.05 considered statistically significant. The total incidence of PONV was 60% with placebo, 45% with metoclopramide, 23% with dexamethasone, and 13% with the combination of dexamethasone plus metoclopramide. None of the dexamethasone plus metoclopramide group patients (p < 0.05 versus groups 1 and 2) and one dexamethasone group patient (p < 0.05 versus group 1) required antiemetic rescue, as compared with four patients in the metoclopramide group and six patients in the placebo group. Pain scores, the time to the first request for analgesia, and side effects were similar across the study groups.

Conclusions

Dexamethasone and the combination of dexamethasone plus metoclopramide were more effective in preventing PONV than metoclopramide and placebo.

Keywords

Laparoscopic cholecystectomyPostoperative nausea and vomitingDexamethasoneMetoclopramide

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • V. Nesek-Adam
    • 1
  • E. Grizelj-Stojčić
    • 1
  • Ž. Rašić
    • 2
  • Z. Čala
    • 2
  • V. Mršić
    • 1
  • A. Smiljanić
    • 1
  1. 1.Department of AnesthesiologyResuscitation and Intensive Care, Sveti Duh General HospitalZagrebCroatia
  2. 2.University Department of SurgerySveti Duh General HospitalZagrebCroatia