Intra-operative dexmedetomidine reduces early postoperative nausea but not vomiting in adult patients after gynaecological laparoscopic surgery: A randomised controlled trial.
Few studies have investigated the use of dexmedetomidine in patients with a high risk of postoperative nausea and vomiting (PONV) following gynaecological laparoscopic surgery.



To investigate if the intra-operative use of dexmedetomidine could reduce the incidence of PONV in this patient population.



A randomised, double-blind, placebo-controlled trial.



A tertiary hospital in Beijing, China.



130 adult patients scheduled for gynaecological laparoscopic surgery.



Patients in the dexmedetomidine group (Dex group, n = 65) received a loading dose of dexmedetomidine (0.5 μg kg over 10 min) before induction of anaesthesia, followed by a continuous infusion (0.1 μg kg h) until the end of surgery. Patients in the control group (Ctrl group, n = 65) received volume-matched normal saline. Propofol and remifentanil were used for induction and maintenance of anaesthesia. Intravenous patient-controlled analgesia with morphine was provided after surgery.



The incidence of 24-h PONV.



The incidence of nausea within the first 2 postoperative hours was lower in the Dex group than in the Ctrl group [0% (0/65) vs. 9% (6/65), P = 0.037]. The overall incidence of PONV within the first 2 postoperative hours was slightly lower in the Dex group than in the Ctrl group, but the difference was not statistically significant [5% (3/65) vs. 14% (9/65), P = 0.069]. There was no significant difference between the two groups regarding the incidence of 24-h PONV.



For adult patients undergoing gynaecological laparoscopic surgery, supplemental use of dexmedetomidine during general anaesthesia reduced the incidence of early postoperative nausea but not vomiting within the 24 h after surgery.



Chinese Clinical Trial Registry ChiCTR-IPR-15006914.
From the Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, Beijing, China.
Zhi-Yu
ZY
Geng
Ya-Fei
YF
Liu
Shan-Shan
SS
Wang
Dong-Xin
DX
Wang
D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D002681:China / Q000453:epidemiology; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D020250:Postoperative Nausea and Vomiting / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*
D018712:Analgesics, Non-Narcotic; D020927:Dexmedetomidine