EFFICACY OF PROPHYLACTIC ANTIEMETICS IN PATIENTS UNDERGOING LAPAROSCOPIC SURGERIES: A DESCRIPTIVE STUDY
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Date
2025-08-31
Authors
Atieh, Raghad
Journal Title
Journal ISSN
Volume Title
Publisher
An-Najah National University
Abstract
Background: Postoperative Nausea and Vomiting (PONV) are popular, inconvenient surgical complications, in particular under general anaesthesia; in addition, no functional pharmacologic antiemetics have been developed.
Aims: This study aimed to compare the efficacy of prophylactic intravenous metoclopramide (10 mg) administered prior to extubation with dexamethasone (8 mg) given at the induction of anaesthesia in preventing PONV within the first 24 hours following laparoscopic surgery. The study also sought to assess their influence on the necessity for rescue antiemetic medicine, postoperative pain incidence and severity, occurrence of side effects, and patient satisfaction throughout the recovery phase.
Methods: The study was conducted in a Northern West Bank hospital from October 2024 to April 2025, including 90 patients scheduled for elective laparoscopic surgery. The patients were divided into two groups: one group received 8 mg of intravenous dexamethasone at anaesthesia induction, and the other received 10 mg of metoclopramide before extubation. Nausea severity was measured using a Likert scale, and postoperative pain was assessed using a VAS. Outcomes were evaluated in the PACU and at 6, 12, and 24 hours post-surgery.
Results: The Metoclopramide group manifested significantly less favorable outcomes, with higher nausea intensity (1.82 vs. 1.07), more rescue antiemetic use (44.4% vs. 15.6%), and more side effects like headache (73.3% vs. 42.2%), fatigue (77.8% vs. 46.7%), blurred vision (33.3% vs. 8.9%), and tremor (35.6% vs. 0%) in the PACU. In the ward (0–24 hours), they also had high nausea incidence (84.4% vs. 60%), greater nausea intensity (1.78 vs. 1.16), and more blurred vision and tremor. However, the Dexamethasone group required a higher rescue of antiemetics later (at 6 hours: 17.8% vs. 0%; 6.7% vs. 33.3% from arrival to 24 hours). Pain scores at 2 and 4 hours were higher with Metoclopramide, and satisfaction scores were lower (2.78 vs. 2.96).
Conclusion: Dexamethasone is better than Metoclopramide in to forbid postoperative nausea and vomiting, reducing nausea severity, frequency of adverse effects, and improving patient satisfaction. It also minimize the necessity for rescue antiemetic medications in the PACU, confirming its preference for elective surgery patients.