Preoperative Fasting Abbreviation and its Effects on Postoperative Nausea and Vomiting Incidence in Gynecological Surgery Patients

Abstract Objective To investigate the effects of preoperative fasting abbreviation with a carbohydrate and protein-enriched solution, on postoperative nausea and vomiting (PONV) incidence in gynecological surgery patients, a population naturally at risk for such unpleasant episodes. Methods The present prospective double-blind randomized study was performed at The Hospital Municipal e Maternidade Dr. Odelmo Leão Carneiro (HMMOLC, in the Portuguese acronym), in Uberlândia, state of Minas Gerais, Brazil, in partnership with the Gynecology Department of the Universidade Federal de São Paulo (UNIFESP), approved by the Human Research Ethics Committee of UNIFESP and the board of HMMOLC, and included in the Brazil Platform and in the Brazilian Clinical Trial Registry. After signing the consent form, 80 women, who were submitted to gynecological surgery in the period from January to June 2016, were randomized into 2 groups: control group (n = 42) and juice group (n = 38). They received, respectively, 200 mL of inert solution or liquid enriched with carbohydrate and protein 4 hours presurgery. The incidence, frequency and intensity of PONV were studied using the Visual Analogue Scale (VAS), with statistical analysis performed by the software IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp, Armonk, NY, USA). Results The incidence of nausea and vomiting was lower than in the literature, to this population, with 18.9% (14/74) for the control group and 10.8% (8/74) for the juice group, respectively, with no statistically significant difference between the groups. Conclusion The incidence of nausea and vomiting was lower than in the literature, but it cannot be said that this is due to the abbreviation of fasting. It can provide greater comfort, with the possibility of PONV prevention in patients at risk for these episodes.

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Is Infusion of Subhypnotic Propofol as Effective as Dexamethasone in Prevention of Postoperative Nausea and Vomiting Related to Laparoscopic Cholecystectomy? A Randomized Controlled Trial

BioMed Research International ◽

10.1155/2015/349806 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 10

Author(s):

Mine Celik ◽

Aysenur Dostbil ◽

Mehmet Aksoy ◽

Ilker Ince ◽

Ali Ahiskalioglu ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Postoperative Nausea ◽

Controlled Trial ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Controlled Study ◽

Control Group ◽

Double Blind ◽

Significant Difference ◽

Group D

Background. Postoperative nausea and vomiting (PONV) is one of common complications in patients undergoing laparoscopic cholecystectomy (LC). Aim of this study was to compare the efficacy of subhypnotic (1 mg/kg/h) infusion of propofol with dexamethasone on PONV in patients undergoing LC.Methods. A total of 120 patients were included in this randomized, double-blind, placebo-controlled study. Patients were randomly assigned to 3 groups; patients of group dexamethasone (group D) were administrated 8 mg dexamethasone before induction of anesthesia, patients of group propofol (group P) were infused to subhypnotic (1 mg/kg/h) propofol during operation and patients of group control (group C) were applied infusion of 10% intralipid. The incidence of PONV and needs for rescue analgesic and antiemetic were recorded in the first 24 h postoperatively.Results. In the 0–24 h, the incidence of PONV was significantly lower in the group D and group P compared with the group C (37.5%, 40%, and 72.5%, resp.). There was no significant difference in the incidence of PONV and use of antiemetics and analgesic between group D and group P.Conclusion. We concluded that infusion of propofol 1 mg/kg/h is as effective as dexamethasone for the prevention of PONV during the first 24 hours after anesthesia in patients undergoing LC.

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Comparison of Ondansetron and Granisetron Effects for Prevention of Nausea and Vomiting Following Strabismus Surgery

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.795 ◽

2019 ◽

Vol 7 (19) ◽

pp. 3195-3200

Author(s):

Shirin Salajagheh ◽

Soodeh Kuhestani ◽

Mahdieh Sharifzadeh Kermani ◽

Omid Taheri ◽

Naeimeh Naeimi Bafghi

Keyword(s):

Postoperative Nausea ◽

Rating Scale ◽

Intervention Group ◽

Postoperative Nausea And Vomiting ◽

Strabismus Surgery ◽

Nausea And Vomiting ◽

Control Group ◽

Chi Square ◽

Double Blind ◽

Significant Difference

BACKGROUND: Postoperative nausea and vomiting (PONV) is a common complaint after strabismus surgery that leads to unpleasantness, increased hospitalisation time and increased costs. In severe cases, it can lead to dehydration, electrolyte disturbances, aspiration, pneumonia, and even sutures opening. AIM: This study was conducted to compare the effects of both ondansetron and granisetron on the reduction of PONV after strabismus surgery. METHODS: This randomised, and the double-blind clinical study was conducted on patients with ASA I and II undergoing strabismus surgery with age over 3 years old in Shafa Hospital, Kerman University of Medical Sciences during 2017 under general anaesthesia. Patients with inclusion criteria were randomly assigned to one of three groups including Ondansetron (A), Granisetron (B) and control group (C). Matching cases and controls on drugs were fully completed. Furthermore, 100 μg/kg of Ondansetron was intravenously injected, followed by injection of 40 μg/kg Granisetron for another intervention group. All patients underwent the same anaesthetic procedure and intravenous injection of drugs during anaesthesia induction. The severity of nausea and vomiting in recovery, 6 and 18 hours after the operation were verified according to the Verbal Rating Scale (VRS). Our data were analysed by Chi-square, ANOVA and TUKEY tests via SPSS version 18. RESULTS: There was no significant difference between the three groups in terms of age and sex. The incidence of postoperative nausea in recovery among three groups of A, B and C was determined to be 15, 7.5 and 37.5%, respectively. No significant difference was found between the two groups A and B (P = 0.68), although there was a significant difference between these two groups and group C (P < 0.05). The incidence of nausea at 6 hours after surgery in groups A, B and C was recorded as 40, 15 and 65% respectively, indicating that the incidence of nausea in group B was significantly lower than the other two groups, while showed a significant difference with group A (P = 0.039) and group C (P < 0.05). Also, the incident of nausea between groups was not statistically significant 18 hours after surgery (P < 0.05). Additionally, no significant difference was found in different groups in terms of vomiting incidence in recovery, 6 and 18 hours after surgery (P < 0.05). CONCLUSION: Our study suggests that Granisetron is more effective in preventing PONV during 6 hours after the surgery in comparison with Ondansetron which makes it a favourable alternative for preventing PONV.

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Granisetron versus Granisetron-Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Pediatric Strabismus Surgery: A Randomized Double-Blind Trial

Anesthesiology Research and Practice ◽

10.1155/2016/4281719 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Renu Sinha ◽

Dilip Shende ◽

Souvik Maitra ◽

Neeraj Kumar ◽

Bikash Ranjan Ray ◽

...

Keyword(s):

Postoperative Nausea ◽

Postoperative Nausea And Vomiting ◽

Complete Response ◽

Strabismus Surgery ◽

Nausea And Vomiting ◽

Fisher Exact Test ◽

Double Blind ◽

Exact Test ◽

Oculocardiac Reflex ◽

Significant Difference

Aim.Efficacy of granisetron and combination of granisetron and dexamethasone was evaluated for prevention of postoperative nausea and vomiting (PONV) in children undergoing elective strabismus surgery.Methods.A total of 136 children (1–15 years) were included. Children received either granisetron (40 mcg/kg) [group G] or combination of granisetron (40 mcg/kg) and dexamethasone (150 mcg/kg) [group GD]. Intraoperative fentanyl requirement and incidence and severity of oculocardiac reflex were assessed. PONV severity was assessed for first 24 hours and if score was >2, it was treated with metoclopramide. Postoperative analgesia was administered with intravenous fentanyl and ibuprofen.Results.The demographic profile, muscles operated, and fentanyl requirement were comparable. Complete response to PONV in first 24 hours was observed in 75% (51/68) of children in group G and 76.9% (50/65) of children in group GD, which was comparable statistically (p=0.96, Fisher exact test; OR 1.11, 95% CI 0.50, 2.46). Incidence of PONV between 0 and 24 hours was comparable. One child in group G required rescue antiemetic in first 24 hours and none of the children had severe PONV in group GD. There was no significant difference in incidence or severity of oculocardiac reflex.Conclusion.Dexamethasone did not increase efficacy of granisetron for prevention of PONV in elective pediatric strabismus surgery. Registration number of clinical trial wasCTRI/2009/091/001000.

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Evaluation of the efficacy of Granisetron over Droperidol in the prevention of Postoperative Nausea and Vomiting following open Cholecystectomy

JMS SKIMS ◽

10.33883/jms.v14i1.63 ◽

2011 ◽

Vol 14 (1) ◽

pp. 11-14

Author(s):

Abdul Qayoom Lone ◽

Shruti Sharma ◽

Mohamad Ommid ◽

Showkat H Nengroo ◽

Imtiyaz Naqash

Keyword(s):

General Anesthesia ◽

Postoperative Nausea ◽

Open Cholecystectomy ◽

Randomized Study ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Physical Status ◽

Double Blind ◽

Post Operative Nausea ◽

To Receive

BACKGROUND: Post operative nausea and vomiting (PONV) continue to be frequent occurrences, even when conventional antiemetics are prophylactically used. OBJECTIVE: To compare the efficacy of Granisetron over Droperidol in the prevention of PONV in patients undergoing elective open cholecystectomy under general anesthesia. MATERIAL & METHODS: In this double blind randomized study, 100 adult patients with physical status ASA I and II, (age, 20-60 years), were randomly allocated into two groups, X or Y, to receive either injection Granisetron hydrochloride (3 mg i/v) or Droperidol (2.5 mg i/v), 5 min prior to induction of general anesthesia. The incidence of nausea and vomiting was recorded every six hourly for a period of 24 hour after the surgery. RESULTS: 6 (12%) patients in the granisetron group and 20 (40%) patients in the Droperidol group reported an emetic episode, (p = 0.002); the incidence of PONV in the total 24 hr period after the surgery, 54% in the granisetron group and 76% in Droperidol group (p = 0.022) CONCLUSIONS: It was found that granisetron is superior to Droperidol in the prevention of postoperative nausea and vomiting. JMS 2011;14(1):11-14

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Dexmedetomidine, Ketamine and Lidocaine Infusion for Prevention of Postoperative Nausea and Vomiting in Laparoscopic Gynecological Surgery: Randomized Trial

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i2331191 ◽

2021 ◽

pp. 101-109

Author(s):

Aya Ibrahim Moustafa ◽

Mohamed Elsayed Afandy ◽

Hesham Mohamed Marouf El Demairy ◽

Hoda Alsaid Ahmed Ezz

Keyword(s):

Postoperative Nausea ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Morphine Consumption ◽

Control Group ◽

Study Group ◽

Gynecological Surgery ◽

Opioid Sparing ◽

Clinically Significant ◽

Post Operative Nausea

Background: The intraoperative use of large bolus doses or continuous infusions of potent opioids may be associated with increased analgesic consumption postoperatively. In ambulatory surgery, opioid related side effects, such as postoperative nausea and vomiting (PONV), prolonged sedation, ileus and urinary retention may delay recovery and discharge or cause unanticipated hospital readmission. The aim was to evaluate the effect of opioid sparing technique via infusion of dexmedetomidine, ketamine and lidocaine on post-operative nausea and vomiting in laparoscopic gynecological surgery. Methods: A total of 80 patients were randomly allocated into 2 groups, 40 patients each. Control group (group c) received fentanyl while, Study group (group S) received infusion of a mixture of dexmedetomidine, ketamine and lidocaine. The PONV impact scale, intraoperative consumption of isoflurane and fentanyl and post operative 24 hr. morphine consumption were measured. Results: 18 (45%) patients of control group experienced PONV versus 7 (17.5%) patients of study group and it was clinically significant. Clinically significant vomiting was observed in10 (25%) patients of control group and 1 (2.5%) patient of study group. There was a marked reduction in fentanyl, isoflurane and 24 hours’ morphine consumption in group S compared to group C. Conclusion: Opioid sparing anesthesia with dexmedetomidine, ketamine and lidocaine infusion are superior to fentanyl for prevention of post-operative nausea and vomiting and reduction of isoflurane and, fentanyl consumption and provides better patient satisfaction in laparoscopic gynecological surgery.

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Effect of Supplemental Perioperative Oxygen 80% in Postoperative Nausea and Vomiting in Patients Undergoing Cataract Surgery

Archives of Anesthesia and Critical Care ◽

10.18502/aacc.v5i2.750 ◽

2019 ◽

Author(s):

Aliakbar Keykha ◽

Mahshid Ashrafzadeh ◽

Alireza Rahat Dahmardeh ◽

Bibi Mahdie Khodadadi Hosseini

Keyword(s):

Cataract Surgery ◽

Incidence Rate ◽

Postoperative Nausea ◽

Postoperative Nausea And Vomiting ◽

Supplemental Oxygen ◽

Nausea And Vomiting ◽

Chi Square ◽

Double Blind ◽

Double Blind Clinical Trial ◽

Significant Difference

Background: Postoperative nausea and vomiting (PONV) leads to an increase in intraocular pressure (IOP) and its side effects, which should be controlled using the least complicated method. Therefore, the purpose of this study was to evaluate the effect of 80% supplemental perioperative oxygen on PONV in patients undergoing cataract surgery. Methods: The present double-blind clinical trial was conducted on 201 patients undergoing cataract surgery. The subjects were selected by convenience sampling method and randomly divided into two groups of oxygen 30% administration and oxygen 80% administration. The operation of patients was performed with the same surgical procedure and team. After the operation, the incidence rate of PONV was recorded in both groups and compared along with other variables by SPSS software using descriptive statistics and chi-square. Results: There was no significant difference in age and sex between the two groups. The incidence rate of PONV was high in both groups, with statistically significant higher value in the group with 30% supplemental oxygen compared to the group with 80% supplemental oxygen (p=0.000). Conclusion: The use of 80% perioperative oxygen concentration could reduce the PONV severity

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Perbandingan Aromaterapi Pepermin dengan Ondansetron Intravena sebagai Terapi Rescue Mual Muntah Pascaoperasi Mastektomi

Jurnal Anestesi Perioperatif ◽

10.15851/jap.v7n1.1587 ◽

2019 ◽

Vol 7 (1) ◽

pp. 25-32

Author(s):

Arna Fransisca ◽

Iwan Fuadi ◽

Dewi Yulianti Bisri

Keyword(s):

Randomized Controlled Trial ◽

Postoperative Nausea ◽

Controlled Trial ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Chi Square ◽

Double Blind ◽

Consecutive Sampling ◽

Randomized Controlled ◽

Significant Difference

Mual muntah pascaoperasi merupakan salah satu komplikasi anestesi dan operasi yang menjadi perhatian khusus karena memengaruhi kualitas pelayanan kesehatan, memperpanjang lama perawatan, dan meningkatkan angka morbiditas perioperatif. Pascaoperasi payudara berkaitan dengan angka kejadian mual muntah pascaoperasi yang tinggi. Beberapa konsensus penatalaksanaan mual muntah pascaoperasi merekomendasikan pemberian terapi nonfarmakologi dengan aromaterapi sebagai terapi rescue untuk mengatasi mual muntah pascaoperasi. Tujuan penelitian ini adalah membandingkan aromaterapi pepermin dengan ondansetron sebagai terapi rescue dalam menurunkan kejadian mual muntah pascaoperasi mastektomi. Penelitian ini merupakan penelitian eksperimental yang dilakukan secara prospektif dengan desain penelitian double blind randomized controlled trial dan consecutive sampling terhadap 32 subjek penelitian yang menjalani operasi mastektomi elektif dan memenuhi kriteria inklusi di RSUP Dr. Hasan Sadikin Bandung pada bulan Juli–September 2018. Pada penelitian ini, data ordinal diuji dengan Uji Mann Whitney dan untuk data kategorik diuji dengan uji chi-square. Hasil penelitian ini didapatkan penurunan kejadian mual muntah pascaoperasi yang signifikan pada kelompok pepermin dibanding dengan kelompok ondansetron dengan perbedaan yang bermakna (p<0,05) pada penilaian menit kedua dan menit kelima setelah perlakuan. Simpulan, aromaterapi pepermin efektif menurunkan kejadian mual muntah pascaoperasi mastektomi dan dapat digunakan sebagai alternatif terapi atau terapi tambahan untuk penatalaksanaan mual muntah pascaoperasi.Comparison of Peppermint Aromatherapy with Ondansetron Intravenous as a Rescue for Postoperative Nausea Vomiting after Mastectomy SurgeryPostoperative nausea and vomiting are among anesthesia and surgery complications that receive special considerations as it affects the quality of healthcare services, prolongs care, and increases perioperative morbidities. The incidence of postoperative nausea and vomiting is high in patients that have undergone breast surgery. The consensus for postoperative nausea and vomiting management recommends non-pharmacological treatments, one of which is through the use of aromatherapy as a rescue to resolve postoperative nausea and vomiting. This study aimed to compare the effects of peppermint aromatherapy and ondansetron as a rescue in reducing the incidence of postoperative nausea and vomiting after elective mastectomies. This was a prospective experimental double blind randomized controlled trial study with consecutive sampling on 32 research subjects underwent elective mastectomies and met the inclusion criteria in Dr. Hasan Sadikin General Hospital in July–September 2018. The ordinal data were tested using the Mann Whitney statistics test and the categorical data using the chi square test. The results show a significant decrease in nausea and vomiting incidence in the peppermint group compared to the ondansetron group with significant difference (p<0.05) in two minutes and five minutes after treatment. In conclusion, peppermint aromatherapy is effective in reducing the incidence of postoperative nausea and vomiting after mastectomies and can be used as an alternative or additional treatment in managing postoperative nausea and vomiting.

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Effects of Dexmedetomidine on Postoperative Nausea and Vomiting in Adult Patients Undergoing Ambulatory Thyroidectomy: A Randomized Clinical Trial

Frontiers in Medicine ◽

10.3389/fmed.2021.781689 ◽

2021 ◽

Vol 8 ◽

Author(s):

Cuiyu Xie ◽

Caihui Zhang ◽

Hao Sun ◽

Yao Lu

Keyword(s):

Relative Risk ◽

Postoperative Nausea ◽

Prospective Trial ◽

Postoperative Nausea And Vomiting ◽

Adult Patients ◽

Nausea And Vomiting ◽

Severe Nausea ◽

Double Blind ◽

Pain Scores ◽

Significant Difference

Background: Postoperative nausea and vomiting (PONV) is a common and disturbing problem in patients undergoing ambulatory thyroidectomy. This prospective trial aimed to explore whether dexmedetomidine (DEX) combined with azasetron (AZA) can further drop the incidence of PONV in patients undergoing ambulatory thyroidectomy compared with AZA.Methods: This single-center, randomized, double-blind trial involved 172 adult patients undergoing ambulatory thyroidectomy. The individuals were randomized to DEX + AZA group and AZA group. In the DEX + AZA group, patients received dexmedetomidine 0.5 μg kg−1 for 10 min and then the infusion rate was held at 0.1 μg kg−1 h−1 until the completion of the operation, while the same amount of 0.9% saline in the AZA group. At the completion of the surgery, 10 mg azasetron was administered to every patient in both groups. The primary outcome was the incidence of 24 h PONV after ambulatory thyroidectomy. The secondary outcomes included residence time in recovery room, pain scores, severity of nausea, and adverse events.Results: No significant difference was found in the incidence of 24-h PONV between the DEX + AZA group and the AZA group [36% (30 of 84) vs. 38% (32 of 84); relative risk, 0.94; 95% confidence interval (CI), 0.63–1.40; P = 0.749]. The incidence of severe nausea was similar between the DEX + AZA group and the AZA group [57% (12 of 21) vs. 43% (9 of 21); relative risk, 1.33; 95% CI, 0.72–2.50; P = 0.355].Conclusions: Intraoperative dexmedetomidine combined with azasetron failed to drop the incidence of 24-h PONV compared with azasetron alone in patients undergoing ambulatory thyroidectomy.

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The Effect of Ginger and Ondansetron on Post-Operative Nausea and Vomiting in Patients Undergoing Eye Surgery: A Triple-Blind Clinical Trial

Shiraz E-Medical Journal ◽

10.5812/semj.102883 ◽

2020 ◽

Vol In Press (In Press) ◽

Author(s):

Shahnam Sedighmaroufi ◽

Ali Abbaskhani Davanloo ◽

Parisa Moradimajd ◽

Hamidreza Samaee ◽

Mohammad Lavaie

Keyword(s):

Postoperative Nausea ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Control Group ◽

Eye Surgery ◽

Significant Difference ◽

Placebo Capsule ◽

Group A ◽

Group B ◽

Post Operative Nausea

Background: Postoperative nausea and vomiting (PONV) is still a common complication that occurs frequently at the time of recovery from eye surgery. Objectives: The present study aimed to compare the effect of oral Ondansetron and Ginger on the frequency and severity of postoperative nausea and vomiting in patients undergoing eye surgery. Methods: A total of 148 patients were randomly assigned to Ginger, Ondansetron, and placebo groups. Group A received a Ginger capsule (1,000 mg), group B Ondansetron capsule (16 mg), and group C placebo capsule with 30 ml water, one hour before surgery. The frequency of nausea and vomiting and the severity of nausea were recorded immediately after recovery, 1, 2, and 4 hours after recovery. Also, some side effects following prescription such as headache, stomach ache, dizziness, and cardiac arrhythmias were recorded. Results: Of the 148 participants, 54% were men, and 46% were women. The average age was in group Ginger (36.14 ± 2.17), group Ondansetron (36.24 ± 2.49), and group placebo (36.24 ± 2.20). There was no significant difference in the frequency of vomiting between the three groups immediately after recovery (P = 0.19) and 4 hours after surgery (P = 0.18). However, the frequency of vomiting in Ginger and Ondansetron groups 1 and 2 hours after the surgery was significantly lower than that in the control group (P = 0.003). No significant difference was observed in the severity of nausea between the three groups at certain times (P > 0.05). There was no significant difference in terms of the need for injection antiemetic drugs after surgery (P = 0.2). Conclusions: Ginger and Ondansetron can reduce the frequency of vomiting. However, Ginger was more effective, safer, and less expensive than Ondansetron; therefore, it may be a better substitute for Ondansetron to prevent PONV.

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Adding dexmedetomidine to morphine-based analgesia reduces early postoperative nausea in patients undergoing gynecological laparoscopic surgery: A randomized controlled trial

10.21203/rs.2.17025/v2 ◽

2019 ◽

Author(s):

Huai Jin Li ◽

Shan Liu ◽

Zhiyu Geng ◽

Xue Ying Li

Keyword(s):

Laparoscopic Surgery ◽

Postoperative Nausea ◽

Controlled Trial ◽

High Risk Patient ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Controlled Study ◽

Control Group ◽

Loading Dose ◽

Double Blind

Abstract Background: Few studies have investigated the effect of dexmedetomidine on postoperative nausea and vomiting (PONV) in patients underwent gynecological laparoscopic surgery. We investigated if adding dexmedetomidine to a morphine-based patient-controlled analgesia (PCA) could decrease the incidence of PONV in this high-risk patient population. Methods: In this prospective, randomized, double-blind and placebo-controlled study, 122 patients underwent gynecological laparoscopic surgery were assigned into two groups. Patients in the dexmedetomidine group (Group Dex) received a loading dose of dexmedetomidine 0.4μg/kg before the end of surgery, followed by morphine 0.5mg/ml plus dexmedetomidine 1μg/ml for postoperative i.v. PCA. Patients in the control group (Group Ctrl) received normal saline before the end of surgery, followed by morphine 0.5mg/ml alone for postoperative i.v. PCA. PCA pump was programmed as followed: bolus dose 2ml, lockout interval 8 minutes and background infusion at a rate of 1ml/h. The primary outcome was the incidence of nausea and vomiting within the first postoperative 24 hours. Results: Although there were no significant differences in regard to the total incidence of PONV (41.0% vs 52.5%, P=0.204), PONV score, time to first onset of PONV, or the need for rescue antiemetics within the first postoperative 24 hr between the two groups, the incidence of nausea and total PONV during the first 2h period was significantly lower in the Group Dex than in the Group Ctrl (9.8% vs 24.6%, P=0.031 and 0.031, respectively). More patients in Group Dex were over sedated or had bradycardia during the PACU compared with Group Ctrl (P=0.040 and 0.036, respectively). Conclusion: Adding dexmedetomidine to morphine-based PCA with a loading dose might reduce the incidence of early postoperative nausea but not total PONV within 24h after surgery in patients undergoing gynecological laparoscopic surgery.

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