Key result
Preoperative IV dexamethasone cuts postoperative nausea and vomiting by ~68% versus placebo.
Why the study?
Does preoperative intravenous dexamethasone reduce postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy?
RCT (n=138)
Randomized
No
Does preoperative intravenous dexamethasone reduce postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy?
Absolute Risk Reduction: 0.32 (95% CI 0.15–0.49)
Absolute Event Rate: 16.66% vs 52.77%
Absolute Risk Reduction: 32%
p-value: p=0.001
A single preoperative dose of 8 mg intravenous dexamethasone significantly reduces postoperative nausea and vomiting and the need for antiemetics in patients undergoing laparoscopic cholecystectomy.
Supports preoperative 8 mg dexamethasone to reduce PONV in laparoscopic cholecystectomy; confirms efficacy in this surgical population.
Background: Postoperative nausea and vomiting is reduced if inj Dexamethasoneis given preoperatively in patient undergoing Laparoscopic Cholecystectomy. The aim of thisprospective randomized, controlled trial was to look into effectiveness of dexamethasone beforesurgery may improve nausea, vomiting after surgery in patients undergoing laparoscopiccholecystectomy. Study Design: Prospective randomized study. Setting: Department of Surgery,King Edward Medical University, Lahore - Pakistan. Period: Nov 2010 to April 2012. Methods: 138Patients with Laparoscopic Cholecystectomy were randomized to receive 08 mg Dexamethasone(n=66) or placebo (n=72) intravenously before surgery. Seven patients were excluded on accountof already on steroid treatment due to various reason. Vomiting and nausea were seen in next 24hours after operation. Dexamethasone has minimal side effect after single dose administration. Sixpatients (12%) has nausea and vomiting in treatment group while 26 (47%) in the control group(p<0.001). Patient having dexamethasone, five (10%) need antiemitics as compare to 24 (44%)of those receiving placebo (p<0.001). Conclusion: Single dose of Inj Dexamethasone givenpreoperatively reduce nausea and vomiting markedly in Laparoscopic Cholecystectomy and maybe routinely used in Laparoscopic procedure.
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Azeem et al. (2015) conducted an RCT in Postoperative nausea and vomiting (PONV) (n=138). Dexamethasone vs. Placebo (saline) was evaluated on Postoperative nausea and vomiting within 24 hours (ARR 0.32, 95% CI 0.15 to 0.49, p=0.001). A single 8 mg preoperative dose of intravenous dexamethasone significantly reduced the incidence of postoperative nausea and vomiting from 52.77% to 16.66% compared to placebo (ARR 0.32, p=0.001).
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