Surgical Endoscopy

, Volume 21, Issue 10, pp 1855–1861

The effects of preoperative rofecoxib, metoclopramide, dexamethasone, and ondansetron on postoperative pain and nausea in patients undergoing elective laparoscopic cholecystectomy

  • Marc Antonetti
  • Orlando Kirton
  • Phiet Bui
  • Arben Ademi
  • Ilene Staff
  • Judith A. Hudson-Civetta
  • Richard Lilly
Article

DOI: 10.1007/s00464-007-9501-8

Cite this article as:
Antonetti, M., Kirton, O., Bui, P. et al. Surg Endosc (2007) 21: 1855. doi:10.1007/s00464-007-9501-8

Abstract

Background

No trial to date has evaluated the combined effect of preoperative Rofecoxib, Metoclopramide, Dexamethasone, and Ondansetron on postoperative pain and nausea in patients undergoing laparoscopic cholecystectomy (LC).

Methods

A prospective randomized double-blinded placebo-controlled trial was conducted on patients undergoing elective LC. The patients in the intervention group received Rofecoxib 25 mg PO. Additionally the study group received Metoclopramide 10 mg and Dexamethasone 4 mg; and Ondansetron 4 mg intravenously. Pain and nausea were rated preoperatively, on arrival at the postanesthesia care unit (PACU), at points until discharge, and at 24 hours.

Results

97 patients were in the control group, and 108 received intervention. The intervention group had a smaller proportion of men (10% vs. 23%; p < 0.015). There were differences in: length of stay (LOS) until discharge criteria met (12.88 vs. 9.85 hours, p = 0.0006), pain rating on arrival to floor (3.55 vs. 2.48, p = 0.003); highest pain rating (4.38 vs. 3.56, p = 0.032), highest nausea rating (2.99 vs. 1.47, p = 0.001), worst nausea since discharge (2.58 vs. 1.26, p = 0.005), and the use of postoperative anti-emetics in women (64% vs. 37.1%, p = 0.001).

Conclusions

The use of this preoperative regimen resulted in decreased LOS, maximum pain, and nausea ratings. Patients in the intervention group required less postoperative anti-emetics.

Keywords

LaparoscopicCholecystectomyPostoperative painPostoperative nauseaPain managementNausea management

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Marc Antonetti
    • 1
  • Orlando Kirton
    • 2
  • Phiet Bui
    • 1
  • Arben Ademi
    • 3
  • Ilene Staff
    • 3
  • Judith A. Hudson-Civetta
    • 2
  • Richard Lilly
    • 4
  1. 1.Department of SurgeryDavid Grant Medical CenterTravisUSA
  2. 2.Department of SurgeryHartford Hospital, University of ConnecticutHartfordUSA
  3. 3.Department of Research AdministrationHartford HospitalHartfordUSA
  4. 4.Department of AnesthesiaHartford Hospital, University of ConnecticutHartfordUSA