Dextrose Containing Fluid and the Postoperative Nausea and Vomiting in the Gynecologic Laparoscopic Surgery
Condition: Postoperative Nausea and Vomiting
MeSH terms: Nausea; Vomiting; Postoperative Nausea and Vomiting
Study type: Interventional

Summary: 
      The investigators tested the hypothesis that administration of intravenous dextrose as a
      maintenance fluid in gynecologic laparoscopic surgery would reduce the incidence and severity
      of postoperative nausea and vomiting (PONV) compared with normal saline solution in the same
      dose.

      A prospective randomized double blinded controlled study was conducted. Eighty six
      participants were randomized to dextrose solution (n= 42) or normal saline solution (n= 44).
      The Bellville postoperative nausea and vomiting scores were recorded until 24 hours after
      surgery.
    

Detailed description: 
      Postoperative nausea and vomiting (PONV) is a major complication in laparoscopic gynecologic
      surgery. There are limited data and conflicting results from previous studies related to the
      types of intravenous fluid and a reduction in PONV. The incidence of nausea is slightly
      greater than the incidence of vomiting (50% vs. 30%). General anesthesia increased the
      likelihood of PONV 11 times compared with other types of anesthesia. Laparoscopic surgery can
      further increase the incidence of PONV to 80%.Identified risk factors of PONV included
      female, history of motion sickness, nonsmoking, younger age, general anesthesia, use of
      volatile anesthetics and nitrous oxide, opioids, duration of anesthesia, and types of surgery
      (cholecystectomy, laparoscopic, gynecological). Adequate intravenous fluid hydration is
      another effective strategy for reducing the baseline risk for PONV (Evidence A2). Previous
      studies showed that there was no difference in efficacy between crystalloids and colloids
      when similar volumes were used in surgeries associated with minimal fluid shifts. While
      liberal intravenous fluid administration, such as 30 ml/ kg of sodium lactate solution,
      reduced the incidence of PONV after gynecologic laparoscopy compared to another group
      receiving 10 ml/kg of sodium lactate solution, this strategy did not reduce the PONV in other
      surgical procedures such as thyroidectomy. Among crystalloid solutions, results from previous
      studies were conflicting regarding the benefit of intravenous dextrose administration to
      reducing the PONV. Hypovolemia with and without hypoglycemia after overnight fasting were
      believed to exacerbate PONV.

      The investigators hypothesized that intraoperative infusion of dextrose solution could reduce
      the incidence and severity of PONV. The investigators proposed to determine the relationship
      between types of fluid administration and antiemetic requirement and serum glucose in
      paricipants scheduled for the gynecologic laparoscopy.
    

Intervention name(s): dextrose solution; saline solution
Intervention type(s): Other; Other
Intervention description(s): The patients received 5%D/N/2 during surgery; The patients received NSS during surgery
Other intervention name(s): 5% dextrose in half strength saline solution; normal saline solution
Intervention MeSH terms: Pharmaceutical Solutions
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: a prospective randomized double-blind controlled study of the incidence and severity of postoperative nausea and vomiting in female participants receiving different types of intravenous fluid solution
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: postoperative nausea; postoperative vomiting; gynecologic laparoscopic surgery