Anesthesia: Essays and Researches  Login  | Users Online: 751 Home Print this page Email this page Small font sizeDefault font sizeIncrease font size
Home | About us | Editorial board | Ahead of print | Search | Current Issue | Archives | Submit article | Instructions | Copyright form | Subscribe | Advertise | Contacts
Year : 2018  |  Volume : 12  |  Issue : 2  |  Page : 396-401

Minimum effective dose of dexamethasone in combination with midazolam as prophylaxis against postoperative nausea and vomiting after laparoscopic cholecystectomy

1 Department of Anaesthesia and Pain Medicine, Hind Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
2 Department of Anaesthesia, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
3 Department of Anaesthesia, Javitri Hospital, Lucknow, Uttar Pradesh, India

Correspondence Address:
Dr. Rakhi Gupta
D1-302 Akash Enclave, Vrindavan Yojana, Sector 6A, Telibagh, Lucknow, Uttar Pradesh
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aer.AER_19_18

Rights and Permissions

Background: Postoperative nausea and vomiting (PONV) affects 20% and 30% of patients. As many as 60%–80% patients at high risk may be affected. Dexamethasone (D) and midazolam (M) are well studied as antiemetic. Use of D can be associated with certain undesirable side effects so minimum dose is preferred. M is a routinely used premedicant. Hence, this study was designed with both D and M in high risk patients for PONV to find minimum effective dose of D. Aims: To determine the minimum dose of D that combined with M would provide effective prophylaxis of PONV after laparoscopic cholecystectomy (LC) in patients at high risk for PONV. Setting and Design: This is a prospective, randomized double-blind trial. Materials and Methods: One hundred and fifty-five patients scheduled for elective LC were randomized to 5 groups of 31 each. Group C was given normal saline, and the rest were administered D 1 mg (group MD1), 2 mg (group MD2), 4 mg (group MD4), or 8 mg (group MD8) in combination with 0.04 mg/kg M at induction. The incidence of nausea, vomiting, severity of nausea, and the use of rescue antiemetic and postoperative pain was analyzed. Statistical Analysis: Chi-square test was used to compare incidence of study variables. Independent Student's t-test was used for continuous variables. Demographic data were compared using ANOVA. P < 0.05 was considered statistically significant. Results: The incidence of nausea was significantly lower in group MD4 (29%) and MD8 (6%) compared to placebo group (71%) (P < 0.001) and of vomiting was significantly lower in groups of MD2 (58%), MD4 (48%), and MD8 (6%) compared with placebo (90%) (P < 0.001) at 24 h. There was significant reduction in nausea, pain severity, and incidence of use of rescue antiemetic in MD4 and MD8 groups with no discernable side effects of the drugs. Conclusion: We conclude that 4 mg D with M and 2 mg D with M is effective for prevention of nausea and vomiting, respectively, in patients at high risk for PONV undergoing LC.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded81    
    Comments [Add]    

Recommend this journal