Effect of Intraoperative Dextrose Infusion for Prevention of Postoperative Nausea and Vomiting in Diagnostic Gynecologic Laparoscopy

Abstract

Objective: Laparoscopic procedures are accompanied with a high occurrence of nausea and vomiting after surgery. This study aimed to evaluate the effectiveness of prophylactic intraoperative infusion of dextrose 5% in the avoidance of postoperative nausea and vomiting (PONV). Materials and Methods: In this randomized, double-blind, placebo-controlled clinical trial, 70 ASA class I women, aged 20-40 years scheduled for diagnostic laparoscopy for infertility were studied. Following induction of anesthesia, study group (n = 35) received Ringer's solution 10 mL/kg/h with glucose 500 mg/kg (dextrose 5%) and placebo group (n = 35) received Ringer's solution with normal saline 0.9% in the same volume intraoperatively. The incidence and severity of PONV according to a 4-point scale (0-3) in the post-anesthesia care unit (PACU) and during the first 24 postoperative hours, the first request for antiemetic, and overall antiemetic consumption were compared between 2 groups. Results: The overall incidence of PONV was certainly lower in the study group compared with the placebo group (22.85% vs. 45.71%; P = 0.03). Severity of PONV was significantly lower in the study group (1.14 +/- 0.32) compared to the placebo group (2.50 +/- 0.27) (P = 0.03). There was a statistically significant difference between 2 groups regarding the first request for antiemetic after surgery (7.1 +/- 1.13 vs. 5.71 +/- 1.76 hours, P = 0.04) and total dose of antiemetic (metoclopramide, 60 vs. 100 mg, P = 0.001). There was no significant difference in perioperative blood sugar levels between 2 groups (P = 0.46). Conclusion: Intraoperative infusion of dextrose 5% was found to be an efficacious method in the prevention/reduction of PONV without any significant difference in postoperative blood sugar levels in patients undergoing diagnostic gynecologic laparoscopy.