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

Study Objective The aim of this study was to explore the relationship between intravenous 5% dextrose infusion during emergence from anesthesia to post-operative nausea and vomiting (PONV) in patients following 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 gynecological laparoscopic surgery. Interventions On completion of surgery, participants were randomized into the test group (receive 5% dextrose) and control group (receive ringer 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 postoperative anesthesia care unit (PACU). Baseline characteristics were statistically similar between the two 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 to 1.37; P=0.794). However, fewer patients experienced PONV in the test group than in the control group during 0-1 hours (6.0% vs 20.0%; RR, 0.85; 95% CI, 0.73 to 0.99; P=0.024) and 1-3 hours (14.5% vs 32.0%; RR, 0.80; 95% CI, 0.64 to 0.99; P=0.033) postoperatively. Additionally, recovery time in PACU was less in test group (17.07±6.36 vs 22.04±7.33; mean difference [MD], -4.97; 95% CI, -7.62 to -2.32; P<0.001) and pain score were lower in test group during 0-0.5 hours postoperatively (2.29±1.74 vs 3.08±1.64; MD, -0.79; 95% CI, -1.45 to -0.13; P=0.019). Conclusion In patients following gynecologic laparoscopic surgery, post-anesthesia 5% dextrose infusion may be useful in improving the early management of PONV and pain response and may warrant further study.