Key result
The combination of propofol and dexamethasone significantly reduced the incidence of postoperative nausea and vomiting to 20% compared to 38% with propofol alone in patients undergoing emergency appendectomy.
Why the study?
Postoperative nausea and vomiting is common after appendectomy, and propofol's effectiveness as a sole antiemetic agent may be limited.
Does the combination of propofol and dexamethasone reduce postoperative nausea and vomiting compared to propofol alone in patients undergoing emergency appendectomy?
RCT (n=100)
Randomized into two equal groups
No
Does the combination of propofol and dexamethasone reduce postoperative nausea and vomiting compared to propofol alone in patients undergoing emergency appendectomy?
Absolute Event Rate: 20% vs 38%
p-value: p=0.047
The combination of propofol and dexamethasone significantly reduces the incidence of postoperative nausea and vomiting compared to propofol alone in patients undergoing emergency appendectomy.
Supports adding dexamethasone to propofol for PONV prevention in emergency appendectomy; extends multimodal antiemetic data to urgent procedures.
Background: Postoperative nausea and vomiting (PONV) remains a common and distressing complication following surgery, particularly after appendectomy. While propofol has inherent antiemetic properties, its effectiveness as a sole agent may be limited. Dexamethasone, a corticosteroid, has also demonstrated efficacy in reducing PONV when used adjunctively. Aim: This study aimed to compare the effectiveness of propofol alone versus the combination of propofol and dexamethasone in preventing PONV in patients undergoing emergency appendectomy. Methods: A total of 100 patients, aged 18-60 years and of either gender, undergoing emergency appendectomy were enrolled in this study, conducted from October to December 2013. Patients were randomly divided into two equal groups (n=50). Group A received propofol (1-2 mg/kg) as both an induction and antiemetic agent. Group B received the same dose of propofol along with dexamethasone (8 mg) administered preoperatively. The incidence of PONV was recorded postoperatively and compared between both groups. Results: The results indicated that the combination of propofol and dexamethasone significantly reduced the incidence of PONV compared to the use of propofol alone. Patients in Group B experienced fewer episodes of nausea and vomiting, demonstrating superior antiemetic efficacy. Conclusion: The findings support that while propofol has antiemetic effects, its combination with dexamethasone is significantly more effective in reducing postoperative nausea and vomiting following appendectomy. This combination should be considered in clinical practice for better PONV prophylaxis.
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Mohsin et al. (2025) conducted an RCT in Postoperative nausea and vomiting (PONV) (n=100). Propofol and dexamethasone vs. Propofol 1-2 mg/kg alone was evaluated on Total incidence of postoperative nausea and vomiting (PONV) within 24 hours (p=0.047). The combination of propofol and dexamethasone significantly reduced the incidence of postoperative nausea and vomiting to 20% compared to 38% with propofol alone in patients undergoing emergency appendectomy.
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