[Prophylaxis of postoperative nausea and vomiting in morbidly obese patients undergoing laparoscopic gastroplasties: a comparative study among three methods].
OBJECTIVE
Videolaparoscopic bariatric surgeries are associated with a high incidence of postoperative nausea and vomiting. Those events can lead to significant morbidity, increase hospitalization costs, as well as patient dissatisfaction. The objective of this study was to compare different prophylaxis protocols of postoperative nausea and vomiting in videolaparoscopic gastroplasties.


METHODS
This is a randomized prospective study with 77 patients undergoing videolaparoscopic gastroplasty. Patients were divided into four groups as follows: Cont group, control (n = 19) where antiemetics were not administered; Dexa group (n = 16), patients received dexamethasone; Onda group (n = 20), patients received ondansetron; and Dexa+Onda group (n = 22), patients received dexamethasone and ondansetron. All patients underwent standardized anesthesia and postoperative analgesia with intravenous morphine. Patients who were taking gastric protectors or antiemetics and those with hiatal hernia were excluded. Demographic data, duration of the surgery, doses of morphine, and development of nausea and vomiting in the immediate postoperative period (up to six hours) were recorded.


RESULTS
Demographic data and doses of morphine administered did not differ among the groups (One-way ANOVA). The incidence of nausea and/or vomiting in the different groups was: Cont group - 78.94%; Dexa group - 62.25%; Onda group - 50%; and Dexa+Onda group - 18.8% (p = 0.0002).


CONCLUSIONS
The incidence of postoperative nausea and vomiting in videolaparoscopic gastroplasties was more effectively reduced with the association of ondansetron and dexamethasone than with each drug separately.
CET, SBA, Hospital da Beneficência Portuguesa, São Paulo.
Melissa Nespeca
MN
Mendes
Rosana de Souza
Rde S
Monteiro
Fernando Antonio Nogueira da Cruz
FA
Martins
D000328:Adult; D000932:Antiemetics / Q000627:therapeutic use*; D003907:Dexamethasone / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D017294:Ondansetron / Q000627:therapeutic use*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011446:Prospective Studies; D055815:Young Adult
D000932:Antiemetics; D017294:Ondansetron; D003907:Dexamethasone