Dextrose Containing Fluid and the Postoperative Nausea and Vomiting in the Gynecologic Laparoscopic Surgery
Dextrose Containing Fluid and the Postoperative Nausea and Vomiting in the Gynecologic Laparoscopic Surgery
The investigators tested the hypothesis that administration of intravenous dextrose as a
 maintenance fluid in gynecologic laparoscopic surgery would reduce the incidence and severity
 of postoperative nausea and vomiting (PONV) compared with normal saline solution in the same
 dose.

 A prospective randomized double blinded controlled study was conducted. Eighty six
 participants were randomized to dextrose solution (n= 42) or normal saline solution (n= 44).
 The Bellville postoperative nausea and vomiting scores were recorded until 24 hours after
 surgery.
Postoperative nausea and vomiting (PONV) is a major complication in laparoscopic gynecologic
 surgery. There are limited data and conflicting results from previous studies related to the
 types of intravenous fluid and a reduction in PONV. The incidence of nausea is slightly
 greater than the incidence of vomiting (50% vs. 30%). General anesthesia increased the
 likelihood of PONV 11 times compared with other types of anesthesia. Laparoscopic surgery can
 further increase the incidence of PONV to 80%.Identified risk factors of PONV included
 female, history of motion sickness, nonsmoking, younger age, general anesthesia, use of
 volatile anesthetics and nitrous oxide, opioids, duration of anesthesia, and types of surgery
 (cholecystectomy, laparoscopic, gynecological). Adequate intravenous fluid hydration is
 another effective strategy for reducing the baseline risk for PONV (Evidence A2). Previous
 studies showed that there was no difference in efficacy between crystalloids and colloids
 when similar volumes were used in surgeries associated with minimal fluid shifts. While
 liberal intravenous fluid administration, such as 30 ml/ kg of sodium lactate solution,
 reduced the incidence of PONV after gynecologic laparoscopy compared to another group
 receiving 10 ml/kg of sodium lactate solution, this strategy did not reduce the PONV in other
 surgical procedures such as thyroidectomy. Among crystalloid solutions, results from previous
 studies were conflicting regarding the benefit of intravenous dextrose administration to
 reducing the PONV. Hypovolemia with and without hypoglycemia after overnight fasting were
 believed to exacerbate PONV.

 The investigators hypothesized that intraoperative infusion of dextrose solution could reduce
 the incidence and severity of PONV. The investigators proposed to determine the relationship
 between types of fluid administration and antiemetic requirement and serum glucose in
 paricipants scheduled for the gynecologic laparoscopy.
Inclusion Criteria:

 -  ASA I-II

 -  elective surgery

 -  Gynecologic laparoscopic surgery

 -  give informed consent

 Exclusion Criteria:

 -  pregnancy

 -  DM

 -  congestive heart failure