The effect of timing and dosing of 5% and 10% dextrose versus saline on postoperative nausea and vomiting in high-risk women following ambulatory surgeries: a randomized double-blind controlled trial

BACKGROUND: A common complication after outpatient surgeries is postoperative nausea and vomiting (PONV) which is concomitant with high levels of patient distress and dissatisfaction. Perioperative dextrose-containing fluid administration has been used as a non-pharmacologic preventive measure against postoperative nausea and vomiting (PONV). However, its efficacy remains unclear. This study aimed to compare different concentrations of dextrose solution on PONV for 24 hours after surgery.METHODS: This is a randomized double-blind controlled study where 120 women were divided into three equal groups. Group C was infused with IV 0.9% saline 100 mL/h for two hours (200 mL) starting one hour before anesthesia and ending during surgery. Group D5%, was infused with dextrose 5%. Group D10%, was infused with D10%. PONV within 24 hours was compared between groups by PONV score. Other outcomes were the antiemetic drugs needed, VAS Score, total fentanyl consumption, hemodynamic data, unplanned admission, and complications.RESULTS: The incidence of nausea and vomiting was significantly reduced in dextrose 10% and 5% patients in comparison to the control group (five patients [12.5%], 18 [42.5%], and 39 [87.5%] respectively). The request for antiemetic drugs decreased significantly in groups D10% and 5% than in group C (36 [90%], 29 [72.5%] and 19 [47.5%] patients did not receive any antiemetics, P=0.002). Postoperative pain prevalence in patients with PONV was significantly different only at 24 h, P=0.03.CONCLUSIONS: There was a potential role for preoperative IV infusion of dextrose 10% solution that significantly reduces the incidence and severity of PONV and pain in patients at high risk for PONV.