Effect of Preoperative Oral Carbohydrate Fluid on Post Operative Nausea and Vomiting in Laparoscopic Cholecystectomy Patients Under General Anesthesia

Abstract

Background: Postoperative nausea and vomiting (PONV), an unpleasant complication following anaesthesia and surgery has various components such as nausea, retching and vomiting. Although PONV is usually self-limiting and non-fatal, it often causes substantial patient distress and dissatisfaction, augmenting healthcare costs by delaying discharge from post anaesthesia care units and causing unexpected hospital re-admissions. Different pharmacological and non-pharmacological approaches have been used for preventing PONV. Nonetheless, the most effective prophylactic regime has not been determined. Methods: We conducted a prospective randomised study for evaluation of effect of preoperative oral carbohydrate fluid (GROUP- C) and placebo drink (clear water) (GROUP-P) on PONV in 90 adult patients undergoing laparoscopic cholecystectomy surgery under general anaesthesia. The number of episodes of nausea, retching and vomiting, total requirement of antiemetic dose in 24 hours, pre and postoperative blood glucose levels, patient satisfaction score, VAS score and haemodynamic parameters were recorded in the two groups and statistical analysis was done. Results: Demographic data was comparable between the two groups with respect to age, gender and BMI. The surgical time and intra-abdominal pressures throughout the surgery were similar in the two groups. In our study the pre-induction blood glucose levels were found to be higher in group C and preoperative thirst was found to be less in group P. Both the groups were comparable in terms of number of episodes of PONV, total requirement of anti-emetic dose in 24 hours, patient satisfaction and well-being. VAS score for pain and requirement of analgesic dose was also similar in the two groups. Conclusion: Pre-operative oral monosaccharide carbohydrate fluid does not prevent PONV, alter requirement of antiemetic, patient satisfaction and well-being, VAS score for pain, requirement of analgesic dose in patients undergoing laparoscopic cholecystectomy under general anaesthesia, as compared to placebo drink.

Keywords

• Antiemetic
• Carbohydrate
• Laparoscopic cholecystectomy
• Postoperative complication
• Nausea and Vomiting
• VAS score