Preoperative use of dexamethasone in reducing vomiting and hospital stay in patients undergoing laparoscopic cholecyscetomy

Background: laparoscopic cholecystectomy despite its minimally invasive nature,leads to high incidence of post operative vomiting,a major cause of morbidity. in routine metoclopramide and dexamethasone are used as an antiemetic but scarce data exists regarding their efficacy. aim: to determine the preoperative use of dexamethasone in reducing postoperative vomiting and hospital stay in patients undergoing laparoscopic cholecystectomy as compared to metoclopramide. methods: this randomized trial was carried out at surgical outpatient department of bahawal victoria hospital. total patients in study were one hundred and fourteen. two groups of patients were made i.e. a and b. after pre-operative preparation of patient for surgery 8 mg of dexamethasone were given intravenously to group a at the time of induction and 10 mg of metoclopramide was given group b. to see the antiemetic effect of both drugs in reducing vomiting patient was closely observed in post-operative period after every six hours duration in first 24 hours period. results: the mean age of group a was 42.7±1.24 years and in group-b,44.1±1.05 years. there were 25(43.86%) males and 32(56.14%) were females in group-a while in group-b,27(47.37%) were males and 30(52.63%) were females. 17(29%) patients suffered post-operative nausea and vomiting after administration of dexamethasone in group-a while 33(57%) suffered in group b (metoclopramide) (p value=0.03). when compared the post-operative hospital stay,it was longer i.e. 1.43±0.52 days in group-a while 2.16±0.65 days in group b (p value < 0.001). conclusion: preoperative use of dexamethasone is more effective in reducing postoperative vomiting and hospital stay in patients undergoing laparoscopic cholecystectomy as compared to metoclopramide. © 2016,lahore medical and dental college. all rights reserved.