Impact of combining dexmedetomidine to ondansetron and dexamethasone for prophylaxis against postoperative nausea and vomiting after laparoscopic bariatric surgery

Background
Postoperative nausea and vomiting (PONV) are common and highly distressing following laparoscopic bariatric surgery. However, there is inadequate evidence regarding the impact of combining dexmedetomidine to dexamethasone and ondansetron. We aimed to study the impact of combining dexmedetomidine to dexamethasone and ondansetron in the prevention of PONV.
Patients and methods
Seventy-two adult patients scheduled for laparoscopic bariatric surgery were randomized in this double-blind study to receive either single dose of dexmedetomidine 1 µg/kg; ondansetron 4 mg; dexamethasone 8 mg (group D, =36) or ondansetron 4 mg and dexamethasone 8 mg (group B, =36), after induction of anaesthesia. Anaesthesia administration was performed similarly for both groups using a standard protocol. During the first 24 h postoperatively, the primary outcomes were the incidence of PONV. The severity of PONV and use of rescue antiemetic were the secondary outcomes. -Test and Student's -test were utilized to evaluate significant differences in categorical and continuous variables.
Results
The incidence of PONV was significantly reduced in group D (13.9 vs. 52.8%, <0.001). The severity of PONV was significantly lower in group D (34.22±10.48 vs. 62.50±13.34, =0.03). Ondansetron consumption was reduced significantly during 24 h in group D (2.33±2.93 vs. 3.58±2.68, =0.03).
Conclusion
Addition of dexmedetomidine to ondansetron and dexamethasone was efficacious in decreasing incidence, severity of PONV, and the total analgesic consumption during the first 24 h after laparoscopic bariatric surgery.