Effect of Dextrose on Postoperative Nausea and Vomiting
Conditions
Keywords
dextrose infusion, postoperative nausea and vomiting, gynecological laparoscope and hysteroscope
Brief summary
This research aims to investigate the efficacy of preoperative intravenous infusion of dextrose 5% during fasting in lowering the incidence and severity of post-operative nausea and vomiting related to laparoscopic gynaecologic procedures
Detailed description
A history of PONV risk factors will be recorded. After consenting, patients will be assigned using a computerized randomization function to Ringer solution (group R) or 5% dextrose (group D) or control group (group C). Group D will receive 1 mL/kg/h 5% Dextrose infusion, applied preoperatively during fasting until induction of anesthesia. Group R will receive 1 mL/kg/h ringer infusion, applied preoperatively during fasting until induction of anesthesia. Group C will receive no fluids. The anesthesia providers, surgeons, perioperative nurses, postanesthesia care unit (PACU) nurses and investigators will be blinded to group assignment throughout. As for pre-medication, all patients will receive IV midazolam (0.02 mg/kg). Anesthesia will be induced with propofol (1.5-2 mg/kg), fentanyl (1-2 μg/kg) and atracurium(o.5mg/kg) to facilitate endotracheal intubation. The lungs will be mechanically ventilated and anesthesia will be maintained with isoflurane in O2/air. Intraoperative IV maintenance fluid will be standardized at 3 mL/kg/h with additional IV crystalloid given as needed at the discretion of the anesthesia provider if arterial blood pressure decreased >20% from baseline. For postoperative pain relief, paracetamol 1 g will be given I.V. during surgery in all patients and continued orally after operation (1g every 6 h). In addition, all patients will be ambulated within 6 h after completion of surgery. Standardized antiemetic and analgesic rescue medications will be available. Patients will receive no rescue antiemetic medication when the VRS score is 0 to 2; 1 dose of rescue medication when the VRS score is 3 to 6; and ≥2 doses for nausea score of 7 to 10, to reduce the nausea score to 0 to 2.
Interventions
OTHERgroup d
this group will receive 1 mL/kg/h 5% Dextrose infusion, applied preoperatively during fasting until induction of anesthesia
OTHERgroup R
this group will receive 1 mL/kg/h ringer infusion, applied preoperatively during fasting until induction of anesthesia
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult female patients scheduled for elective laparoscopic gynecological/hysteroscopic procedures will be considered for inclusion * ASA physical status I and ll.
Exclusion criteria
* patients with a previous history of PONV. * Patients with motion sickness, coagulopathy, diabetes mellitus, or severe hypertension * patients with cardiac, renal or hepatic dysfunction. * patients receiving an antiemetic agent within 24 h before surgery or cases where complications occurs during the surgery * patients who have abnormal blood glucose on the night before surgery * patients who are unable to understand and use the verbal rating scale (VRS);Growth developmental, and motor-mental retardation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| frequency of post-opertive nausea and vomiting in 24 hour | FROM ENROLLMENT TO 24 HOURS AFTER SURGERY | using verbal rating scale (VRS) |
Secondary
| Measure | Time frame |
|---|---|
| TOTAL AMOUNT OF ANTIEMETIC REQUIRED | From end of surgery to 24 hours postoperative |
Contacts
Primary Contactyasmin yasmin hassabelnaby, assistant profesour
Backup Contactyasmin s hassabelnaby, assistant professor
Outcome results
None listed