Comparison of dexmedetomidine and dexamethasone for prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy

Abstract

Background: Postoperative nausea and vomiting (PONV) are usually defined as any nausea, retching, or vomiting that occurs during the first 24 postoperative hours.
Aim: To compare the efficacy of dexmedetomidine and dexamethasone in preventing postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy.
Patients and methods: This meta-analysis compared the efficacy of dexmedetomidine and dexamethasone in preventing postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy. Five studies were included, selected based on predefined inclusion and exclusion criteria to ensure consistency and reliability.
Results: Two studies reported (Intra-operative fentanyl) and all can be used. A significant heterogeneity was detected. Therefore, a random-effect model was used for analysis (I² = 93%, P=0.0003). The combined mean difference and 95% CIs was -12.36 (-17.15 to -7.56). The combined result demonstrates statistically significant difference between groups regarding (Intra-operative fentanyl) (Z= 5.05, P<0.00001). Three studies reported (Overall Post operative vomiting and nausea) and all can be used. A no significant heterogeneity was detected. Therefore, a random-effect model was used for analysis (I² = 0%, P=0.52). The combined mean difference and 95% CIs was 0.94 (0.55 to 1.61). The combined result demonstrates statistically no significant difference between groups regarding (Overall Post operative vomiting and nausea) (Z= 0.23, P=0.82).
Conclusion: Dexmedetomidine and dexamethasone effectively prevent PONV after laparoscopic cholecystectomy, with dexmedetomidine reducing opioid use, offering valuable insights for optimizing perioperative management in this patient population.