Intra-operative dexmedetomidine reduces early postoperative nausea but not vomiting in adult patients after gynaecological laparoscopic surgery: A randomised controlled trial

BACKGROUNDFew studies have investigated the use of dexmedetomidine in patients with a high risk of postoperative nausea and vomiting (PONV) following gynaecological laparoscopic surgery.OBJECTIVETo investigate if the intra-operative use of dexmedetomidine could reduce the incidence of PONV in this patient population.DESIGNA randomised, double-blind, placebo-controlled trial.SETTINGA tertiary hospital in Beijing, China.PATIENTS130 adult patients scheduled for gynaecological laparoscopic surgery.INTERVENTIONSPatients in the dexmedetomidine group (Dex group, n=65) received a loading dose of dexmedetomidine (0.5gkg(-1) over 10min) before induction of anaesthesia, followed by a continuous infusion (0.1gkg(-1)h(-1)) until the end of surgery. Patients in the control group (Ctrl group, n=65) received volume-matched normal saline. Propofol and remifentanil were used for induction and maintenance of anaesthesia. Intravenous patient-controlled analgesia with morphine was provided after surgery.MAIN OUTCOME MEASURESThe incidence of 24-h PONV.RESULTSThe incidence of nausea within the first 2 postoperative hours was lower in the Dex group than in the Ctrl group [0% (0/65) vs. 9% (6/65), P=0.037]. The overall incidence of PONV within the first 2 postoperative hours was slightly lower in the Dex group than in the Ctrl group, but the difference was not statistically significant [5% (3/65) vs. 14% (9/65), P=0.069]. There was no significant difference between the two groups regarding the incidence of 24-h PONV.CONCLUSIONFor adult patients undergoing gynaecological laparoscopic surgery, supplemental use of dexmedetomidine during general anaesthesia reduced the incidence of early postoperative nausea but not vomiting within the 24h after surgery.TRIAL REGISTRATIONChinese Clinical Trial Registry ChiCTR-IPR-15006914.