DOI: 10.36347/sjams.2016.v04i05.037

Pages: 1640-1645

Postoperative nausea and vomiting (PONV) after laproscopic cholecystectomy remains a common problem in spite of introduction of newer antiemetics with better efficacy and safety profiles. None of the available antiemetics is entirely effective, perhaps because most of them act through the blockade on a particular type of receptor. The addition of adjuvants like dexamethasone and promethazine to antiemetics like granisetron can improve the outcome. However, lack of knowledge limits its acceptance. The aim of the present study was to compare the effects of dexamethasone and promethazine as adjuvant to granisetron for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy. In Method 120 patients, aged 25-55 years, scheduled for elective cholecystectomy were enrolled in a randomized, double blinded manner and assigned to one of three treatment regimens: granisetron2mg + 5ml normal saline (Group I), granisetron2mg + dexamethasone 8mg (Group II) and granisetron2mg + promethazine 12.5mg (Group III). Occurrence of PONV along with need for rescue antiemetic during the first postoperative day was compared between groups as a primary outcome. In Results the Complete control of PONV (no emesis, no rescue treatment for 24 hours after administration of study agent) was achieved in only 72.5% of cases in group I, in 95% of cases in group II which is significant (p<0.05) and 87.5% of cases in group III which is not significant (p>0.05). In conclusion, in the surgical setting of laparoscopic cholecystectomy, dexamethasone is better adjuvant than promethazine in reducing the incidence and severity of PONV during the first 24 hrs postoperatively.