الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 71 |  |  |
| | | from | 71 | | |
Abstract
P
ostoperative nausea and vomiting (PONV) is a common distressing symptom in patients undergoing laparoscopic surgery and can contribute to anxiety, dehydration, metabolic abnormality, wound disruption, delayed recovery and other issues.The incidence of PONV varies from 20 to 80 % of all surgeries, and it is an economic and social burden.
The origin of postoperative nausea and vomiting after laparoscopic surgery performed under general anesthesia is not entirely clear, but it is probably multifactorial. The necessity of gas insufflation, which results in the stretching of peritoneum and increased pressure in the peritoneal cavity, is a very important factor provoking nausea and vomiting. Prolonged carbon dioxide insufflations, residual pneumoperitoneum after CO2 insufflation, peritoneum distension, diaphragm irritation, and visceral organ irritation and manipulation have been considered to influence the incidence of PONV.
The recommended pharmacologic antiemetics in adults include 5-HT3 receptor antagonists (ondansetron, dolasetron, granisetron, tropisetron, ramosetron, and palonosetron), dopamine antagonists (domperidone, olanzapine, haloperidol and metoclopramide), neurokinin-1 (NK-1) receptor antagonists (aprepitant, casopitant, and rolapitant), corticosteroids (dexamethasone and methylprednisolone), antihistamines (dimenhydrinate and meclizine), anticholinergics (transdermal scopolamine [TDS]), and miscellaneous (Propofol, Alpha2-Agonists; clonidine and dexmedetomidine, Gabapentin and midazolam).
This study was conducted on 80 patients who underwent elective laparoscopic surgery under general anesthesia who matched the inclusion criteria and were randomly allocated into 2 groups each containing 40 patients.
The first group received Ondansetron 4 mg; the second group received 8 mg Dexamethasone.
The results of our study showed that Dexamethasone 8 mg was as effective as ondansetron 4 mg. Dexamethasone provided a simple, safe, cheap, and effective postoperative nausea and emesis prevention method with the advantage of being cheaper decreasing the economic burden.