Comparative effect of Dexmedetomidine versus Propofol in reducing postoperative nausea and vomiting in gynecological laparoscopic surgery

Nausea and vomiting in the postoperative period occurs in 20% to 30% of patients¡ and together¡ nausea and vomiting are the second most common complaints reported (pain is the most common). PONV can be such an unpleasant experience that patients often rate it worse than postoperative pain. Although the experience is generally self-limited can lead to rare but serious medical complications¡ such as aspiration of gastric contents¡ suture dehiscence¡ esophageal rupture¡ subcutaneous emphysema¡ or pneumothorax. PONV may delay a patient’s discharge from post anesthetic care units (PACUs) and can be the leading cause of unexpected hospital admission after ambulatory anesthesia. Annual PONV-related health care costs approach several hundred million dollars . Many interventions to control PONV has been done. Complications of medical interventions¡ limit the use of each drug. For example¡ Dropridol has placed on the Black Box Warning¡ regarding the risk of cardiac arrhythmias.
Methods and Materials: In this randomized double blind clinical trial including 80 patients American Society of Anesthesiologist (ASA) class I or II who were scheduled for elective laparoscopic gynecologic surgery¡ they were randomly divided into two groups: Propofol and Dexmedetomidine. The data was collected by the first nurse in PACUs and the second nurse in post surgery ward¡ using a questionnaire including age¡ weight and smoking history¡ severity of vomiting and nausea and vomiting. Patients and observers were unaware of the prescribed hypnotic drugs. Assessing the severity of nausea by visual analogue scale (ranging 0 to 10) in 0-2¡ 2-6 and 6-24 hours¡ were carried out. Also having or not having nausea was also recorded.
There were demographic differences between two groups. In the dexmedetomidine group the incidence of nausea and severity of vomiting decreased significantly compared to Propofol (PV=0.001).