A comparative study between small dose dexamethasone, tropisteron, metoclopramide and normal saline in reducing nausea and vomiting after laparoscopic cholecystectomy

Background and objective: Nausea and vomiting are among the most common distressing complications encountered by patients postoperatively. The aim of this study is to evaluate the prophylactic effect of small dose of dexamethasone (5 mg) on postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy (LC). Methods: A prospective double blind placebo controlled study of 160 patients who underwent elective LC at Rizgary Teaching and Hawler Private Hospitals in Erbil, Kurdistan in a period between Jan 2009 and Dec 2009. Preoperatively the patients were allocated randomly to one of the four groups (n = 40 each). 1. The dexamethasone group received dexamethasone 5mg. 2. The metoclopramide group received metoclopramide 10mg. 3. The tropisetron group received tropisetron 2mg. 4. The placebo group received normal saline 2ml. Results: Both the dexamethasone and tropisetron groups were significantly different from the placebo group in the incidence of nausea and vomiting. The differences between the dexamethasone and tropisetron groups were not significant (P = 0.799). Conclusion: : prophylactic IV dexamethasone 5 mg significantly reduces the incidence of PONV in patients undergoing LC.