Dexamethasone for Prevention of Postoperative Vomiting After Laparoscopic Gynecologic Surgery (PONV-DEX-GYN)
Effect of a Preoperative Single Dose of Intravenous Dexamethasone on Postoperative Vomiting in Patients Undergoing Laparoscopic Gynecologic Surgery
Postoperative nausea and vomiting (PONV) are common and distressing complications following laparoscopic gynecologic surgery. This randomized controlled trial evaluated whether a single preoperative intravenous dose of dexamethasone reduces postoperative vomiting compared with placebo and explored patient-related risk factors associated with PONV.
Women undergoing elective laparoscopic gynecologic surgery were randomly assigned to receive dexamethasone (5 mg IV) or placebo at induction of anesthesia. The primary outcome was the incidence of postoperative vomiting within 24 hours, with secondary outcomes including nausea severity, rescue antiemetic use, and postoperative recovery parameters.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
This single-blind randomized controlled trial evaluated the prophylactic efficacy of a single preoperative intravenous dose of dexamethasone for preventing postoperative vomiting in women undergoing elective laparoscopic gynecologic surgery. The study was conducted at Holy Family Hospital, Rawalpindi Medical University, Pakistan, between October 1, 2017, and March 31, 2018.
Eligible women aged 15-65 years were randomized in a 1:1 ratio to receive either dexamethasone 5 mg intravenously or placebo (normal saline) at induction of anesthesia. Perioperative anesthesia and postoperative care were standardized across groups. The primary outcome was the incidence of postoperative vomiting within 24 hours after surgery. Secondary outcomes included nausea severity, need for rescue antiemetics, postoperative opioid use, and recovery parameters such as time to oral intake and mobilization. An exploratory analysis assessed patient-related predictors of postoperative nausea and vomiting, including body mass index and prior history of PONV.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
ICT
-
Islamabad, ICT, Pakistan, 44000
- Department of Gynecology and Obstetrics, Al-Nafees Medical College and Hospital-Isra University
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Female patients aged 15-65 years
- Scheduled for elective laparoscopic gynecologic surgery
- Able to provide written informed consent (for minors, consent obtained from legal guardians)
Exclusion Criteria:
- Prior laparoscopic surgery
- Known hypersensitivity to corticosteroids
- Opioid use within 24 hours preoperatively
- Ischemic heart disease
- Uncontrolled hypertension or diabetes mellitus
- Ongoing antiemetic therapy
- Conversion to open surgery
- Body mass index (BMI) > 30 kg/m²
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Dexamethasone
Single intravenous dose of dexamethasone 5 mg administered at induction of anesthesia prior to surgical incision.
|
Single intravenous dose of dexamethasone 5 mg administered at induction of anesthesia prior to surgical incision.
|
|
Placebo Comparator: Placebo (Normal Saline)
Single intravenous dose of normal saline (placebo) administered at induction of anesthesia.
|
Single intravenous dose of 2 mL normal saline (placebo) administered at induction of anesthesia immediately prior to surgical incision, matched in volume to the dexamethasone administered in the experimental arm.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of postoperative vomiting
Time Frame: Within 24 hours after surgery
|
Proportion of participants experiencing at least one episode of vomiting within 24 hours after surgery.
|
Within 24 hours after surgery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Need for rescue antiemetics
Time Frame: Within 24 hours after surgery
|
Proportion of participants requiring rescue antiemetic medication within 24 hours postoperatively.
|
Within 24 hours after surgery
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Postoperative Complications
- Pathologic Processes
- Signs and Symptoms, Digestive
- Vomiting
- Nausea
- Pathological Conditions, Signs and Symptoms
- Signs and Symptoms
- Postoperative Nausea and Vomiting
- Pharmaceutical Preparations
- Polycyclic Compounds
- Pregnadienes
- Pregnanes
- Steroids
- Fused-Ring Compounds
- Steroids, Fluorinated
- Crystalloid Solutions
- Isotonic Solutions
- Solutions
- Pregnadienetriols
- Dexamethasone
- Saline Solution
Other Study ID Numbers
Other Study ID Numbers
- 101/RMU/2017-09-29
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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