Role of pre-operative dexamethasone as prophylaxis for postoperative nausea and vomiting in laparoscopic surgery

Introduction: Laparoscopic surgery provides tremendous benefits to patients, including faster recovery, shorter hospital stay and prompt return to normal activities. Despite the minimally invasive nature of laparoscopy, high incidence of postoperative nausea and vomiting remains a major cause for morbidity. The aim of the present study was to investigate whether preoperative Dexamethasone can reduce PONV in patients undergoing laparoscopic Surgery.
Materials and Methods: The study included 200 patients undergoing laparoscopic cholecystectomy. We divided the patients into two groups; one group received preoperative Dexamethasone (group 1) and the other group received Ondansetron (group 2). After surgery, patients were observed for any episode of nausea or vomiting, or whether the patient required any anti-emetic drug in the postoperative period.
Results: The two groups, (Dexamethasone and Ondansetron) were comparable in outcome, in terms of post-operative nausea and vomiting, in patients undergoing laparoscopic cholecystectomy. In group I, 24% of patients had nausea, as compared to 30% in group II ( P =0.2481). Similarly, 12% of patients in group I and 18% of patients in group II had vomiting ( P =0.3574).
Conclusion: We conclude that, preoperative intravenous low dose Dexamethasone reduces the incidence of PONV and is comparable to intravenous Ondansetron.

Keywords
Laparoscopic surgery, steroids, preoperative dexamethasone, postoperative nausea and vomiting.