The influence of dexamethasone and ketolgan on postoperative nausea and vomiting
and estimation of risk factors in women undergoing gynecologic laparoscopic
surgeries. [Article in English, Lithuanian]
Author(s): Rimaitis K, Svitojūte A, Macas A.
Affiliation(s): Department of Gynecology and Obstetrics, Kaunas University of Medicine, 50009
Kaunas, Lithuania. kestutis.rimaitis@kmuk.lt
Publication date & source: 2010, Medicina (Kaunas). , 46(4):261-7
The aim of this study was to determine the effect of dexamethasone and ketolgan
on postoperative nausea and vomiting and to evaluate risk factors for
postoperative nausea and vomiting.MATERIAL AND METHODS: A prospective,
double-blind, randomized clinical study was carried out. One hundred fifty-three
ASA I-II women undergoing laparoscopic gynecologic operations were randomized
into three groups: dexamethasone group (n=51), ketolgan group (n=51), and control
group (n=51). Patients in the dexamethasone group were given 4 mg of
dexamethasone intravenously before the induction of general anesthesia, the
ketolgan group received 30-mg ketolgan intravenously, and control group did not
receive any medication. The incidence and severity of postoperative nausea and
vomiting were registered 24 hours after the surgery.
RESULTS: The incidence of postoperative nausea and vomiting in the dexamethasone
group was 13.8%; in the ketolgan group, 37.3%, and in the control group, 58.9%
(P=0.026). Patients with a history of migraine suffered from postoperative nausea
and vomiting in 70.3% of cases and migraine-free patients in 25.8% of cases
(P=0.015). Opioids for postoperative analgesia increased the incidence of
postoperative nausea and vomiting as compared with nonsteroidal anti-inflammatory
drugs (P=0.00002).
CONCLUSIONS: Preoperative medication with dexamethasone significantly reduces the
incidence of postoperative nausea and vomiting. Avoidance of opioids for
postoperative analgesia reduces the incidence of postoperative nausea and
vomiting. Migraine and motion sickness are independent risk factors for
postoperative nausea and vomiting.
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