Prophylactic Use of Pre-Operative Dexamethasone for Prevention of Post-Operative Nausea, Vomiting and Pain in Patients of Laparoscopic Cholecystectomy
Journal Title: International Journal of Medical Research Professionals - Year 2017, Vol 3, Issue 4
Abstract
Context: Laparoscopic cholecystectomy is the gold standard treatment for symptomatic cholelithiasis and there are many factors which can cause nausea, vomiting and pain after laparoscopic cholecystectomy. Aims: To assess the incidence of postoperative nausea, vomiting and pain as well as efficacy and safety of preoperative dexamethasone in preventing postoperative nausea, vomiting and pain in laparoscopic cholecystectomy. Settings and Design: Randomized double blind trial. Methods and Materials: Sixty patients undergoing lap cholecystectomy were randomly allocated into two groups of 30 each to receive either 8mg dexamethasone intravenously 90 minutes preoperatively(group A) or 2ml saline as placebo 90 minutes preoperatively (group B). Results: Incidence of nausea and vomiting was 23.3% in group A whereas in group B it was 60.0%.Similarly, in group A 3 (10%) patients needed rescue antiemetic in the form of ondansetron while in Group B 10 (33.3%) patients needed it. Incidence of post-operative pain at 1hr, 4hr and 8 hr time intervals, was less in group A as compared to group B. However, at 24hr and 48 hr interval, the statistical analysis shows a p value of >0.05 implying statistically insignificant effect of dexamethasone at these time intervals. However no difference in analgesic requirement was noted amongst the two groups. Conclusion: Prophylactic intravenous administration of single dose of Inj. dexamethasone 8mg 90 minutes prior to surgery is effective in reducing PONV and antiemetic requirement after laparoscopic cholecystectomy. It is also associated with statistically significant reduction in post-operative pain in the first 12hrs.
Authors and Affiliations
Kaushal Seth, Sahil Satish Arora, Sushil Mittal, Harnam Singh Rekhi, Amita Mhatre Arora
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