INVESTIGATION OF DEXMEDETOMIDINE, FAMOTIDINE AND METOCLOPRAMIDE EFFICACY FOR PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITUS: WHAT IS THE PREFERABLE CHOICE?

Postoperative nausea and vomitus (PONV) are serious complication subsequent to laparoscopic radical prostatectomy. Although the prevention of PONV states that a single bolus dose of one antiemetic drug is recommended, combining treatment with two or more drugs or continuous antiemetic drug infusion is more effective. Objectives To evaluate and compare the occurrence and severity of postoperative nausea and vomiting (PONV) in the postoperative phases in patients undergoing laparoscopic prostatectomy who receive various antiemetic prophylaxes. Materials and Methods This prospective, comparative study included 40 patients who underwent laparoscopic radical prostatectomy, equally divided into two groups: one receiving intraoperative antiemetic prophylaxis with a combination of two agents Group FM (intra operative receiving metoclopramide and famotidine), and the other with a single agent (receiving intra- and postoperative continuous infusion of Dexmedetomidine) Group DEX. The dry retching and nausea were assessed at five postoperative time points: immediately after extubating, and at 2, 4, 12 and 24 hours. Results Postoperatively, PONV was identified in total 8 (20%) patients in the two groups. The incidence of PONV in group DEX was lower, and it was 15% or 3 patients with grade 1 PONV, versus 25% or 5 patients with grade 2 PONV in group FM. Conclusion Our results indicate that Dexmedetomidine could significantly lower the occurrence and gradus of PONV compared, with combination of Famotidine and Metoclopramide after laparoscopic prostatectomy.