Effect of 5% Dextrose Infusion on Postoperative Nausea and Vomiting in Patients undergoing Laparoscopic Cholecystectomy: A Randomised Controlled Study

Abstract

Introduction: Postoperative Nausea and Vomiting (PONV) is defined as nausea, vomiting, or retching occurring in the postanaesthesia care unit within the first 24 hours of postoperative period. It is most common following laparoscopic cholecystectomy, causing postoperative discomfort and increasing patients’ stay in the postanaesthesia care unit. Aim: To evaluate the effect of a 500 mL infusion of 5% dextrose on PONV in patients undergoing laparoscopic cholecystectomy. Materials and Methods: A randomised controlled study was conducted at Department of Anaesthesiology, ESICMC PGIMSR, Bengaluru, Karnataka, India from January 2019 to June 2020, involving 90 consenting patients who were randomly assigned to two groups. One group (Group-C) received a 500 mL infusion of 5% dextrose, while the other group (Group-D) received Ringer’s lactate 30 minutes before the end of surgery. Anaesthesia and surgical techniques were standardised for all cases. Postoperatively, primary parameters such as the incidence of nausea, vomiting, and retching, and secondary parameters such as rescue antiemetic consumption and changes in blood glucose changes were recorded. The Bellville scale was used to assess PONV. Data were analysed using the Chi-square (χ2 ) test, with a significance level of 0.05. Continuous variables were reported as mean±Standard Deviation (SD), and categorical variables were reported as proportions. Results: Demographic parameters such as age (p=0.601), gender (p=0.259), weight (p=0.802), height (p=0.391), and Body Mass Index (BMI) (p=0.806) were comparable between the two study groups. A 5% dextrose infusion during laparoscopic cholecystectomy reduced nausea and vomiting during the postoperative period (p<0.05), decreased the overall incidence of PONV (p<0.001), and also reduced the requirement for rescue antiemetic dose (p<0.004). When comparing blood sugar levels, Group-D and Group-C showed no significant difference at T1, but there was a significant difference between the both groups at T2 (T1: p=0.211, T2: p<0.001). Conclusion: A 5% dextrose infusion during laparoscopic cholecystectomy reduces the incidence of PONV and decreases the need for rescue antiemetic medication. Additionally, comparing blood sugar levels, Group-D and Group-C showed a significant difference after the drug infusion. Therefore, a 5% dextrose infusion can be recommended as an effective and safe method for the prophylaxis of PONV in laparoscopic cholecystectomy.

Keywords

• antiemetic
• body mass index
• intravenous fluids
• prophylaxis