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Asian J Surg. 2015 Jan;38(1):21-7. doi: 10.1016/j.asjsur.2014.04.005. Epub 2014 Jun 15.

Dexamethasone combined with other antiemetics for prophylaxis after laparoscopic cholecystectomy.

Author information

1
Department of Blood Transfusion, First Affiliated Hospital of Xiamen University, Xiamen, China.
2
Department of Hepatobiliary and Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Oncologic Center of Xiamen, Xiamen, China.
3
Department of Hepatobiliary and Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Oncologic Center of Xiamen, Xiamen, China. Electronic address: zhouyms@yahoo.com.cn.

Abstract

BACKGROUND/OBJECTIVE:

Postoperative nausea and vomiting (PONV) is one of the most common and distressing adverse events after laparoscopic cholecystectomy (LC). A meta-analysis of randomized clinical trials (RCTs) was performed to determine the efficacy and safety of dexamethasone combined with other antiemetic in the prevention of PONV in patients undergoing LC.

METHODS:

A systematic literature search was conducted to identify all relevant RCTs. The primary outcome was PONV in the early period (0-3 hours, 0-4 hours, or 0-6 hours), late period (>6 hours), and the overall period (0-24 hours).

RESULTS:

Nine RCTs with a total of 1089 patients were included in the analysis. Pooled analysis showed that dexamethasone combined with other antiemetics provided significantly better prophylaxis than single antiemetics in the early period [odds ratio (OR): 0.34; 95% confidence interval (CI): 0.21-0.55; p < 0.001], late period (OR: 0.35; 95% CI: 0.22-0.57; p < 0.001), and the overall period (OR: 0.36; 95% CI: 0.27-0.49; p < 0.001). Correspondingly, rescue antiemetic usage was significantly less in the combination therapy group (OR: 0.22; 95% CI: 0.12-0.41; p < 0.001). The most frequently reported adverse events were headache, dizziness, and itching. The incidence of adverse events did not differ between the two groups.

CONCLUSION:

Dexamethasone combined with other antiemetics was significantly better than single antiemetics for prophylaxis of PONV in patients undergoing LC, without apparent side effects.

KEYWORDS:

dexamethasone; laparoscopic cholecystectomy; postoperative nausea and vomiting

PMID:
24942194
DOI:
10.1016/j.asjsur.2014.04.005
[Indexed for MEDLINE]
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