Postoperative Nausea and Vomiting (PONV)
Conditions
Keywords
postoperative nausea and vomiting (PONV), dexamethasone, laparoscopic gynecologic surgery, prophylaxis, risk factors
Brief summary
Postoperative nausea and vomiting (PONV) are common and distressing complications following laparoscopic gynecologic surgery. This randomized controlled trial evaluated whether a single preoperative intravenous dose of dexamethasone reduces postoperative vomiting compared with placebo and explored patient-related risk factors associated with PONV. Women undergoing elective laparoscopic gynecologic surgery were randomly assigned to receive dexamethasone (5 mg IV) or placebo at induction of anesthesia. The primary outcome was the incidence of postoperative vomiting within 24 hours, with secondary outcomes including nausea severity, rescue antiemetic use, and postoperative recovery parameters.
Detailed description
This single-blind randomized controlled trial evaluated the prophylactic efficacy of a single preoperative intravenous dose of dexamethasone for preventing postoperative vomiting in women undergoing elective laparoscopic gynecologic surgery. The study was conducted at Holy Family Hospital, Rawalpindi Medical University, Pakistan, between October 1, 2017, and March 31, 2018. Eligible women aged 15-65 years were randomized in a 1:1 ratio to receive either dexamethasone 5 mg intravenously or placebo (normal saline) at induction of anesthesia. Perioperative anesthesia and postoperative care were standardized across groups. The primary outcome was the incidence of postoperative vomiting within 24 hours after surgery. Secondary outcomes included nausea severity, need for rescue antiemetics, postoperative opioid use, and recovery parameters such as time to oral intake and mobilization. An exploratory analysis assessed patient-related predictors of postoperative nausea and vomiting, including body mass index and prior history of PONV.
Interventions
DRUGDexamethasone
Single intravenous dose of dexamethasone 5 mg administered at induction of anesthesia prior to surgical incision.
OTHERPlacebo (Normal Saline)
Single intravenous dose of 2 mL normal saline (placebo) administered at induction of anesthesia immediately prior to surgical incision, matched in volume to the dexamethasone administered in the experimental arm.
Sponsors
Rawalpindi Medical College
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Intervention model description
Participants were randomized 1:1 to receive either intravenous dexamethasone (5 mg) or placebo at induction of anesthesia, with parallel group assignment.
Eligibility
Sex/Gender
FEMALE
Age
15 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
1. Female patients aged 15-65 years 2. Scheduled for elective laparoscopic gynecologic surgery 3. Able to provide written informed consent (for minors, consent obtained from legal guardians)
Exclusion criteria
1. Prior laparoscopic surgery 2. Known hypersensitivity to corticosteroids 3. Opioid use within 24 hours preoperatively 4. Ischemic heart disease 5. Uncontrolled hypertension or diabetes mellitus 6. Ongoing antiemetic therapy 7. Conversion to open surgery 8. Body mass index (BMI) \> 30 kg/m²
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of postoperative vomiting | Within 24 hours after surgery | Proportion of participants experiencing at least one episode of vomiting within 24 hours after surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Need for rescue antiemetics | Within 24 hours after surgery | Proportion of participants requiring rescue antiemetic medication within 24 hours postoperatively. |
Countries
Pakistan
Outcome results
None listed