Intravenous Dextrose Prevents Postoperative Nausea and Vomiting

A new study claims that a simple intravenous (IV) administration of dextrose following surgery significantly reduces the occurrence of postoperative nausea and vomiting (PONV) and the need for antiemetic medication in the postoperative anesthesia care unit (PACU).

Researchers at Yale University School of Medicine (New Haven, CT, USA) conducted a double-blind randomized placebo-controlled trial of 56 healthy ambulatory surgery patients scheduled for gynecologic laparoscopic and hysteroscopic procedures. The study patients were randomized to receive IV treatment with dextrose 5% in a Ringer's lactate solution (D5LF), while the control group received plain Ringer's lactate solution. Both treatments were given immediately after surgery and were continued as the patients were admitted to the PACU. All patients underwent a similar sevofluorane–vecuronium general anesthesia protocol and received one dose of an antiemetic 30 minutes before the end of anesthesia. The groups were similar in age, weight, anxiety level, previous PONV, previous surgery, nothing by mouth (NPO) status, anesthetic time, preoperative glucose, intraoperative nitrous oxide (NO) and narcotic use, and total weight-based fluid volume received. The researchers found that the patients who received the dextrose solution had significantly lower PONV scores 30 minutes after arriving in the PACU and at discharge, and lower overall PONV scores than the control group. Those in the dextrose group required half the amount of rescue antiemetic medications while in the PACU, and were discharged sooner. The study was presented at the American Society of Anesthesiologists annual meeting, held during October 2009 in New Orleans (LA, USA).

"We can prevent this with dextrose, which is universally available, inexpensive, and very practical," said study presenter Susan Dabu-Bondoc, M.D. "The use of dextrose is really a no-brainer."

Dextrose monohydrate, better known as glucose, is the major source of energy for living cells, and serves as a metabolic intermediate. It is a simple sugar, the right stereoisomer of aldohexose sugar, and is the main sugar that the body manufactures. Glucose can be produced from protein and fat, but is mainly derived from carbohydrates.

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