Comparison of Dexmedetomidine and Dexamethasone for the Prevention of Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy

Summary

Postoperative nausea and vomiting (PONV) remains a common and distressing complication after laparoscopic cholecystectomy despite advances in anesthesia. Both dexmedetomidine and dexamethasone have shown antiemetic properties, but their comparative effectiveness is still debated. To compare the efficacy of dexmedetomidine and dexamethasone in preventing PONV in patients undergoing laparoscopic cholecystectomy. This double-blind randomized controlled trial included 68 ASA I-II patients scheduled for elective laparoscopic cholecystectomy. Patients were randomly allocated to receive either intravenous dexmedetomidine (1 μg/kg) or dexamethasone (8 mg) after induction of anesthesia. PONV was assessed using a standardized scoring system on arrival in the PACU and at 4, 12, and 24 hours postoperatively. Ondansetron was administered as rescue antiemetic when required. This study aims to determine the more effective prophylactic agent for PONV, with the goal of improving postoperative comfort and quality of care in patients undergoing laparoscopic surgery in the local population.

Timeline

Start

2025-06-01

Primary completion

2025-11-15

Completion

2025-11-15

Publications

• Background 12. Bajaj V, Singh S, Sharma R, Taank P, Dwivedi D. Effect of palonosetron monotherapy versus palonosetron with dexamethasone combination therapy for prevention of post operative nausea vomiting in children undergoing strabismus surgery. Int J Biomed Res. 2019 Feb 14;10(2):e5080
• Background Bakri MH, Ismail EA, Ibrahim A. Comparison of dexmedetomidine and dexamethasone for prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. Korean J Anesthesiol. 2015 Jun;68(3):254-60. doi: 10.4097/kjae.2015.68.3.254. Epub 2015 May 28.
• Background 10. Khadka B, Sharma NR. A Prospective comparative study of dexmedetomidine and dexamethasone for prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. J Soc anesthesiol Nepal. 2021 Jul 5;8(1):e307.
• Background Gul G, Bilgic T, Aydin MA. Evaluation of the Effects of Preoperative Dexamethasone Administration on Postoperative Patient Comfort in Laparoscopic Cholecystectomy. Cureus. 2020 May 5;12(5):e7968. doi: 10.7759/cureus.7968.
• Background Jamil K, Qaisar R. The Effect of Dexamethasone on Postoperative Pain in Patients After Laparoscopic Cholecystectomy. Cureus. 2022 Nov 30;14(11):e32067. doi: 10.7759/cureus.32067. eCollection 2022 Nov.
• Background 7. Masoori TA, Gupta K, Agarwal S, Bansal M, Zuberi A, Samad A. Clinical efficacy of dexmedetomidine in two different doses to attenuate the hemodynamic changes during laparoscopic cholecystectomy. Int J Res Med Sci. 2018 Mar;6:959-65.
• Background Jin S, Liang DD, Chen C, Zhang M, Wang J. Dexmedetomidine prevent postoperative nausea and vomiting on patients during general anesthesia: A PRISMA-compliant meta analysis of randomized controlled trials. Medicine (Baltimore). 2017 Jan;96(1):e5770. doi: 10.1097/MD.0000000000005770.
• Background Stoops S, Kovac A. New insights into the pathophysiology and risk factors for PONV. Best Pract Res Clin Anaesthesiol. 2020 Dec;34(4):667-679. doi: 10.1016/j.bpa.2020.06.001. Epub 2020 Jun 10.
• Background Sinha V, Vivekanand D, Singh S. Prevalence and risk factors of post-operative nausea and vomiting in a tertiary-care hospital: A cross-sectional observational study. Med J Armed Forces India. 2022 Sep;78(Suppl 1):S158-S162. doi: 10.1016/j.mjafi.2020.10.024. Epub 2020 Dec 31.
• Background 3. Singh M, Tiwari AB, Taank P, Singh S, Kaur A, Sood M, et al. Comparative study on effects of dexmedetomidine and dexamethasone on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic surgery. J Acute Dis. 2022 Apr 1;11(2):59-64.
• Background Reddy GS, Manjusruthi B, Jyothsna G. Postoperative Nausea and Vomiting Prophylaxis: A Comparative Study of Ramosetron and Palonosetron in Patients Undergoing Laparoscopic Cholecystectomy - A Prospective Randomized Trial. Anesth Essays Res. 2019 Jan-Mar;13(1):68-72. doi: 10.4103/aer.AER_192_18.
• Background Amreek F, Hussain SZM, Mnagi MH, Rizwan A. Retrospective Analysis of Complications Associated with Laparoscopic Cholecystectomy for Symptomatic Gallstones. Cureus. 2019 Jul 16;11(7):e5152. doi: 10.7759/cureus.5152.

Drugs

Indications

No indication recorded.