The Impact of Different Antiemetics on the Nausea in Early Postoperative Period After Laparoscopic Holecystectomy

Postoperative nausea and vomiting (PONV) is a patient-important outcome; patients often rate PONV as worse than postoperative pain. This clinical study was aimed to asses the efficiency of standard aniemetics administration separately or in combination in prevention of PONV in patients who underwent to the same surgical procedure - laparoscopic cholecystectomy. Also, this article could provide a novel information about the best choice for prevention and treatment of PONV. This study included 87 patients divided into four groups according to the postoperative phramacological treatment: First group was control group without treatment, Second group was group of patients with ondasetron treatment in postoperative period, Third group was group of patients with ondasetron+dexamethasone treatment, and fourth group was group of patients with dexamethasone treatment in postoperative period for nausea. PONV was distributed in Ondansetron+Dexamethasone group in the lowest percent (4.5%), which means that this conbination of antiemetics was very effective. Than, Dexamethasone group was in relation with low incidence of PONV (14.3%), and after that were Ondansetron and Control groups. Also smokers and males has lower incidence of PONV, especially in combination with Ondansetron+Dexamethasone treatment.

The incidence of PONV is lower in male smokers patients who were underwent to combination of two antiemetics, ondansetron and dexamethasone compared to monotherapy and female non-smokers. Preventive strategies for PONV must include risk stratification followed by prophylactic approach and also testing the newer antiemetics. Because of the high incidence of postoperative nausea and vomiting as a patient-important outcome, the preventive strategies should be considered as serious condition which requires multimodal approach.