Haloperidol Versus Dexmedetomidine As An Adjuvant to Ondansetron in Postoperative Nausea and Vomiting in Laparoscopic holecystectomy | ||
| The Egyptian Journal of Surgery | ||
| Volume 44, Issue 3, July 2025, Pages 874-883 PDF (787.79 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/EJSUR.2025.342684.1305 | ||
| Authors | ||
| Ashraf Nabil Saleh; Mostafa Mohammed Mohyeldin Abusekkien* ; Laila Ali El-Kafrawi; Mohammed Anwar El-Shafei; Ahmed Abdeldayem Abdelhak | ||
| Department of Anesthesia, Faculty of Medicine, Ain Shams University, Cairo, Egypt | ||
| Abstract | ||
| Background: Postoperative nausea and vomiting (PONV) is a frequent complication of laparoscopic cholecystectomy, adversely affecting case recovery. Multimodal antiemetic strategies, including ondansetron combined with other agents, are often employed for PONV management. Dexmedetomidine, an α2-adrenergic agonist, and haloperidol, a dopamine receptor antagonist, are known for their antiemetic properties, though their comparative efficacy remains uncertain. Patients and Methods: This prospective, randomized, double-blind investigation involved 75 adult cases undergoing laparoscopic cholecystectomy. Participants have been divided into three groups (25 patients each): Group D received dexmedetomidine (0.5μg/kg) with ondansetron (4mg), Group H received haloperidol (2mg) with ondansetron (4mg), and Group O received ondansetron (4mg) alone. The primary outcome was the incidence of postoperative nausea and vomiting (PONV) within 24 hours. Secondary outcomes included the number of nausea/vomiting episodes, time to rescue antiemetic, postoperative pethidine consumption, sedation scores, and hemodynamic stability. Results: Dexmedetomidine combined with ondansetron significantly reduced PONV incidence (40% in Group D) compared to haloperidol (76% in Group H) and ondansetron alone (88%, p-value less than 0.001). Time to rescue antiemetic was longest in Group D (6 hours, p-value equals 0.007). Group D demonstrated lower postoperative pethidine consumption and higher sedation scores than the other groups. Hemodynamic stability was maintained across all groups. Conclusion: Dexmedetomidine combined with ondansetron provides superior PONV prophylaxis and reduces opioid requirements compared to haloperidol with ondansetron or ondansetron alone in cases undergoing laparoscopic cholecystectomy. | ||
| Keywords | ||
| Dexmedetomidine; Haloperidol; Laparoscopic cholecystectomy; ondansetron; Postoperative nausea and vomiting | ||
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