Effective Pharmacological and Non-Pharmacological Methods for Preventing Nausea and Vomiting in Cholecystectomy; a Narrative and Systematic Review

Postoperative nausea and vomiting are common and uncomfortable postoperative complications. Different pharmacological and non-pharmacological methods can be used to reduce or control nausea and vomiting after cholecystectomy. The present study investigates the effectiveness of pharmacological and non-pharmacological methods in reducing or controlling nausea and vomiting in cholecystectomy.

In this narrative and systematic review, to find articles in Persian language, SID and Magiran databases, and Google Scholar search engine, from 2000 to 2020, were searched by 2 authors, separately, using Persian keywords equal to cholecystectomy, nausea, and vomiting. Information of the selected articles including: first author, year of publication of the article, title of the study, sample size, drug used, tools studied, and finally, patients’ outcomes were recorded in the data extraction form. The quality of the reviewed articles was evaluated using a checklist related to clinical trial studies.

In the initial stage of searching for articles, 558 studies were reviewed. The researchers then reviewed the articles found and 544 studies were eliminated due to not being relevant to the subject under study, duplication, and lack of access to the complete article. Finally, 14 studies were used to write this study. Among the studied articles, metoclopramide was evaluated in 7 studies, ondansetron in 6 studies, dexamethasone in 6 studies, gabapentin in 2 studies, and intraperitoneal bupivacaine, propofol, promethazine, ginger, acupressure, and intravenous crystalloid were examined in one study each.

The results of the present study showed that among the pharmacological methods to control nausea and vomiting in patients undergoing cholecystectomy, the first choice of anesthesiologist can be ondansetron. Also, in non-pharmacological methods, acupressure and ginger can both reduce nausea and vomiting after surgery.