Is Intravenous Dextrose Infusion During Emergence From Anesthesia Effective in Improving the PONV in Gynecologic Laparoscopy? A Randomized Controlled Trial

Study Objective: This study aimed to explore the relationship between intravenous 5% dextrose infusion during emergence from anesthesia to postoperative nausea and vomiting (PONV) in patients after gynecologic laparoscopic surgery. Design: This was a double-blind randomized controlled trial. Participants were randomized into the experimental group and control group using a computer -generated random number generator. Intervenors and measurers were blinded to group assignments of the study. Setting: A single academic tertiary medical center. Patients: Patients undergoing gynecologic laparoscopic surgery. Interventions: On completion of surgery, participants were randomized into the test group (receive 5% dextrose) and control group (receive Ringer's lactate solution). Measurements and Main Results: The primary outcome of the present study was the incidence of PONV. Other outcomes included postoperative rescue analgesic and rescue antiemetic, postoperative pain response, and recovery time of postanesthesia care unit. Baseline characteristics were statistically similar between the 2 groups of participants. There were 49 of 105 patients experienced PONV within 24 hours postoperatively. The overall incidence of PONV within 24 hours postoperatively was not significantly different (45.5% vs 48%; relative risk [RR], 0.95; 95% confidence interval [CI], 0.67 - 1.37; p = .794). However, fewer patients experienced PONV in the test group than in the control group during 0 to 1 hours (6.0% vs 20.0%; RR, 0.85; 95% CI, 0.73 - 0.99; p = .024) and 1 to 3 hours (14.5% vs 32.0%; RR, 0.80; 95% CI, 0.64 - 0.99; p = .033) postoperatively. In addition, recovery time in the postanesthesia care unit was less in the test group (17.07 +/- 6.36 vs 22.04 +/- 7.33; mean difference, - 4.97; 95% CI, - 7.62 to - 2.32; p < .001) and pain score was lower in the test group during 0 to 0.5 hours postoperatively (2.29 +/- 1.74 vs 3.08 +/- 1.64; mean difference, - 0.79; 95% CI, - 1.45 to - 0.13; p = .019). Conclusion: In patients after gynecologic laparoscopic surgery, postanesthesia 5% dextrose infusion may be useful in improving the early management of PONV and pain response and may warrant further study. Journal of Minimally Invasive Gynecology (2024) 31, 285 - 294. (c) 2024 AAGL. All rights reserved.