title: Dexamethasone combined with other antiemetics for prophylaxis after laparoscopic cholecystectomy.
abstract: OBJECTIVE
  Postoperative nausea and vomiting (PONV) is one of the most common and distressing adverse events after laparoscopic cholecystectomy (LC). A meta-analysis of randomized clinical trials (RCTs) was performed to determine the efficacy and safety of dexamethasone combined with other antiemetic in the prevention of PONV in patients undergoing LC.
  
  
  METHODS
  A systematic literature search was conducted to identify all relevant RCTs. The primary outcome was PONV in the early period (0-3 hours, 0-4 hours, or 0-6 hours), late period (>6 hours), and the overall period (0-24 hours).
  
  
  RESULTS
  Nine RCTs with a total of 1089 patients were included in the analysis. Pooled analysis showed that dexamethasone combined with other antiemetics provided significantly better prophylaxis than single antiemetics in the early period [odds ratio (OR): 0.34; 95% confidence interval (CI): 0.21-0.55; p < 0.001], late period (OR: 0.35; 95% CI: 0.22-0.57; p < 0.001), and the overall period (OR: 0.36; 95% CI: 0.27-0.49; p < 0.001). Correspondingly, rescue antiemetic usage was significantly less in the combination therapy group (OR: 0.22; 95% CI: 0.12-0.41; p < 0.001). The most frequently reported adverse events were headache, dizziness, and itching. The incidence of adverse events did not differ between the two groups.
  
  
  CONCLUSIONS
  Dexamethasone combined with other antiemetics was significantly better than single antiemetics for prophylaxis of PONV in patients undergoing LC, without apparent side effects.
authors.affiliation: Department of Blood Transfusion, First Affiliated Hospital of Xiamen University, Xiamen, China.
authors.forename: Xiao-Ying
authors.initials: XY
authors.lastname: Si
authors.affiliation: Department of Hepatobiliary and Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Oncologic Center of Xiamen, Xiamen, China.
authors.forename: Lu-Peng
authors.initials: LP
authors.lastname: Wu
authors.affiliation: Department of Hepatobiliary and Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Oncologic Center of Xiamen, Xiamen, China.
authors.forename: Xiu-Dong
authors.initials: XD
authors.lastname: Li
authors.affiliation: Department of Hepatobiliary and Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Oncologic Center of Xiamen, Xiamen, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Hepatobiliary and Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Oncologic Center of Xiamen, Xiamen, China. Electronic address: zhouyms@yahoo.com.cn.
authors.forename: Yan-Ming
authors.initials: YM
authors.lastname: Zhou
mesh_terms: D000932:Antiemetics / Q000008:administration & dosage* / Q000009:adverse effects; D017081:Cholecystectomy, Laparoscopic; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D006801:Humans; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011184:Postoperative Period; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000932:Antiemetics; D003907:Dexamethasone
keywords: dexamethasone; laparoscopic cholecystectomy; postoperative nausea and vomiting