Dexmedetomidine versus Propofol in reducing postoperative nausea and vomiting in gynecologic laparoscopic surgery

Introduction: Post-Operative Nausea and Vomiting (PONV) occurs in 20%-30% of patients, and is the second most common complaints after pain. This unpleasant complication can lead to rare but serious medical complications such as aspiration of gastric contents, suture dehiscence, esophageal rupture, subcutaneous emphysema, or pneumothorax. Annual PONV-related health care costs reach several hundred million dollars. Many interventions have been done to control PONV, but complications of drug interactions limit the use of drugs. For example, Dropridol has been placed on the Black Box Warning because of the risk of cardiac arrhythmias.

Methods: This clinical trial recruited 80 patients with American Society of Anesthesiologist (ASA) class I or II who were scheduled for elective gynecologic laparoscopic 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, including age, weight, smoking history, nausea, vomiting and severity of vomiting. Patients and observers were blinded to the prescribed hypnotic drugs. The severity of nausea was assessed by visual analogue scale (ranging 0 to 10) in 0-2, 2-6 and 6-24 hours. The state of nausea was also recorded.

Results: The incidence of nausea and the severity of vomiting significantly decreased in the dexmedetomidine group compared to the Propofol group (PV=0.001).

Conclusion: The results showed that Dexmedetomidine can reduce the incidence of nausea and severity of vomiting compared to Propofol.