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Role of Intraoperative Dexamethasone with Propofol to Improve Outcome after Laparoscopic Surgeries

Khushboo Dharmani** , H.S. Rawat* , Khushboo Dharmani** , PritamJadhav***

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Indian Journal of Anesthesia and Analgesia 3(1):p 27-31, Jan-Apr 2016. | DOI: DOI : https://dx.doi.org/10.21088/ijaa.2349.8471.3116.5

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Abstract

Despite advances in anesthetic drugs and techniques, post-operative nausea and vomiting (PONV) remain the second most common post-operative complaint after surgery. Despite the increasing attention to postoperative pain control, PONV is still considered a minor complication. In the absence of antiemetic treatment, the estimate puts the incidence of  PONV at 25-30% for all surgical interventions and patient populations. Pharmacological approaches based on anticholinergics, antihistamines, phenothiazines, butyrophenones, benzamides, corticosteroids and serotonin receptor antagonists have been investigated in the prevention    and treatment of  PONV, with      various results. Dexamethasone may offer additional benefits over traditional antiemetics in improving the surgical outcomes. Compared with placebo, 8 mg          of Dexamethasone given intravenously 90 minutes before laparoscopic cholecystectomy (LC) has been demonstrated to reduce PONV significantly. Combination of  both Propofol and Dexamethasone  may reduce the chances of PONV and additionally decreases incidence of sore throat in patients       operated for laparoscopic cholecystectomy. The limitation of  this study was that we could not measure the cuff pressure and did not use fibre optic bronchoscope to assess the amount of tissue damage. Our study was not designed for extended follow up beyond 24 hours, as the process of acute inflammation usually peaks by 24 hours. Sore throat, hoarseness and cough cannot be assessed objectively and there are inter individual variations and hence, a chance of  bias always exists. The BMI of our patients in the two groups were comparable and we used standard  sized tubes of the same manufacturer to ameliorate the possible error due to different tube size and quality. 

Keywords: Dexamethasone; Propofol; Laparoscopy; Metoclop Ramide.

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DOI: DOI : https://dx.doi.org/10.21088/ijaa.2349.8471.3116.5

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