Prevention of postoperative nausea and vomiting with a small dose of propofol alone and combined with dexamethasone in patients undergoing laparoscopic cholecystectomy: A prospective, randomized, double-blind study.
BACKGROUND
A small dose of propofol is directly antiemetic, and is effective for the prevention of postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy (LC). However, this regimen cannot entirely control PONV after LC.


METHODS
In a prospective, randomized, double-blind study, patients received intravenously either placebo (Intralipid), propofol 0.5 mg/kg, or propofol 0.5 mg/kg plus dexamethasone 8 mg at the end of surgical procedure. A standard anesthetic technique, including sevoflurane and air in oxygen, was used. Emetic symptoms (nausea, retching, and vomiting) were recorded during the first 24 hours after anesthesia.


RESULTS
A total of 120 patients (59 men and 61 nonpregnant women) were enrolled, and each treatment group consisted of 40 patients. The incidence of patients experiencing PONV during the first 24 hours after anesthesia was 33% with propofol (P = 0.003), 15% with propofol plus dexamethasone (P = 0.001), when compared to 65% with placebo. The efficacy of propofol combined with dexamethasone was superior to that of propofol alone (P = 0.029). No clinically important adverse events due to the study drugs were observed in any of the groups.


CONCLUSIONS
Propofol 0.5 mg/kg combined with dexamethasone 8 mg is more effective than propofol alone for the prevention of PONV during the first 24 hours after anesthesia in patients undergoing LC.
Fujii
Y
Y
Department of Anesthesiology, University of Tsukuba Institute of Clinical Medicine, Tsukuba City, Ibaraki, Japan. yfujii@med.toho-u.ac.jp
Nakayama
M
M
D000328:Adult; D000932:Antiemetics / Q000627:therapeutic use*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D003907:Dexamethasone / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D015742:Propofol / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome
D000932:Antiemetics; D003907:Dexamethasone; D015742:Propofol