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- Title
Efficacy of metoclopramide with dexamethasone in comparison with metoclopramide alone for postoperative vomiting after open laparoscopic cholecystectomy.
- Authors
Muneer, Muhammad Nadeem; Malik, Shoaib; Majeed, Abdul
- Abstract
Background: Post operative vomiting is one of the most undesirable events in general anaesthesia that causes discomfort and irritation after surgery. Factors that increase the incidence include female gender, smoking, age, duration of surgery, intraoperative use of opioids and nitrous oxide. Metoclopramide acts centrally asdopamine receptor antagonist and peripherally as cholinomimetic at specific muscarinic receptors. Dexamethasone probably acts by prostaglandin antagonism, serotonin inhibition in gut, release of endorphins and by its anti-inflammatory membrane stabilizing effect. Single dose of Dexamethasone has no side effects. Objective: To determine the anti-emetic efficacy of metoclopramide plus dexamethasone compared to metoclopramide alone in terms of postoperative vomiting in patients undergoing elective open/laparoscopic cholecystectomy. Methods: Total 110 patients who have undergone elective open/ laparoscopic cholecystectomy were divided into two equal groups. Patients were intubated with endotracheal tube. Patients were observed for post-operative vomiting during first 24 hours. Descriptive statistics were calculated and stratification was done. Chi-square test was applied, P-value ≤0.05 was considered as significant. Results: In both Group-A and Group-B 41.8% had open while 58.2% patients had laparoscopic cholecystectomy. In Group-A, vomiting was observed in 40.0% patients and 47.3% in Group-B. In Group-A, mild vomiting episodes were observed in 25.5%, moderate in 9.1%, and severe in 5.5% cases. In Group-B, mild in 16.4%, moderate in 18.2%, and severe in 12.7% episodes were observed. The efficacy was 85.5% in group-A, and 69.1% in Groups. The association was significant with p=0.041. Conclusion: It was concluded that combination of metoclopramide and dexamethasone is superior in preventing postoperative vomiting.
- Subjects
VOMITING treatment; METOCLOPRAMIDE; CHOLECYSTECTOMY; DEXAMETHASONE; POSTOPERATIVE period; LAPAROSCOPIC surgery; THERAPEUTICS
- Publication
Pakistan Journal of Surgery, 2016, Vol 32, Issue 2, p111
- ISSN
0258-8552
- Publication type
Article