Intraperitoneal versus Intravenous Dexamethasone Effect on Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy

Post-operative nausea and vomiting (PONV) is a common unwanted effect in patients undergoing laparoscopic cholecystectomy (LC). This study compared the effect of intraperitoneal versus intravenous dexamethasone for reducing PONV after laparoscopic cholecystectomy surgeries.

to compare the efficacy of intraperitoneal versus intravenous administration of dexamethasone in reducing the incidence of PONV after LC surgeries.

Ninety patients, American Society of Anesthesiologists physical status I–II, scheduled for laparoscopic cholecystectomy surgery were randomized to receive 8 mg dexamethasone intraperitoneally (IP) (n = 45) or intravenously (IV) (n = 45). The primary outcome was the PONV incidence during the first 24 h after laparoscopy. Secondary outcomes included visual analogue scale (VAS) pain scores, total analgesic consumption during the first 24 h postoperatively, the need for rescue antiemetic drugs, and the incidence of complications that may accompany these medications.

The incidence of nausea in the IV group was 26.7% (12 patients) and that in the IP group was 6.7% (3 patients) in the first 24 hours post-operatively (P = 0.011). There were no significant differences in the incidence of retching or vomiting, or the need for rescue antiemetics between the 2 groups. In terms of side effects, patients in the IP group had a lower rate of side effects than those in the IV group (6.7% vs. 24.4%, P = 0.020). The mean VAS pain score and total pethidine consumption for the first 24 hours postoperatively were lower in the IP group than in the IV group. However, these differences did not reach statistical significance.

Intraperitoneal injection of dexamethasone at a dose of 8 mg in patients undergoing Laparoscopic Cholecystectomy surgery reduces significantly the incidence of postoperative nausea, in comparison to the intravenous route.