Impact of the combination of dexmedetomidine and azasetron on the prevention of postoperative nausea and vomiting in patients undergoing laparoscopic surgery

This study evaluated the effectiveness of combining dexmedetomidine with azasetron for the prevention of postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy. Ninety-four patients scheduled for laparoscopic cholecystectomy under general anesthesia were randomly assigned to two groups, with 47 in each. The azasetron group received 10 mg azasetron prior to surgery, while the combination group received 10 mg azasetron and 0.5 μg/kg dexmedetomidine. Outcomes assessed included PONV incidence within 48 h postoperatively, pain scores using the Visual Analog Scale (VAS), the need for rescue analgesics, intraoperative opioid consumption, heart rate (HR), mean arterial pressure (MAP), and hospital stay duration. The combination therapy group exhibited significantly lower rates of nausea at 12–24 h (10.6 % vs. 27.7 %; p = 0.04) and 24–36 h (12.8 % vs. 34.0 %; p = 0.01), as well as a reduced overall PONV incidence (34.0 % vs. 57.4 %; p = 0.02). VAS pain scores were significantly lower within the first 36 h ( p < 0.05), and intraoperative fentanyl use was reduced in the combination group ( p < 0.05). HR was lower within 44 h postoperatively ( p < 0.05), while MAP was reduced within 32 h ( p < 0.05). There was no significant difference in the length of hospital stay between groups. Adding dexmedetomidine to azasetron enhances PONV prevention compared to azasetron alone in laparoscopic surgery patients. It also reduces opioid consumption, improves postoperative pain control, and stabilizes hemodynamic parameters, making it a promising combination for clinical practice. • Dexmedetomidine plus azasetron lowered PONV incidence in laparoscopic surgery patients. • The combination therapy reduced intraoperative opioid use compared with azasetron alone. • Patients in the combination group had less pain, lower heart rate, and reduced mean arterial pressure. • Dexmedetomidine combined with azasetron was more effective for PONV prevention and pain relief.