A Comparative Prospective Assessment of Preoperative 5% Dextrose and Normal Saline Loading on Outcomes Following Laparoscopic Cholecystectomy

TL;DR

This study compares preoperative 5% dextrose and normal saline to see which is better at reducing postoperative pain and nausea after laparoscopic cholecystectomy.

Contribution

The study provides new evidence that preoperative dextrose reduces postoperative pain and nausea compared to normal saline.

Findings

Preoperative dextrose reduced postoperative abdominal pain and nausea compared to normal saline.

Female sex, ASA I status, and BMI correlated with increased pain and nausea in subgroup analyses.

No significant difference was found in vomiting or discharge fitness between the groups.

Abstract

Background: Laparoscopic cholecystectomy is still accompanied by postoperative pain, nausea, and vomiting, and the use of intravenous dextrose, though suggested to decrease the mentioned complications, has not been confirmed yet. The purpose of the study was to evaluate the effects of intravenous preoperative 5% dextrose and normal saline on postoperative pain, nausea, vomiting, and discharge fitness in patients undergoing elective laparoscopic cholecystectomy.

Methods: 100 patients undergoing laparoscopic cholecystectomy were involved in a comparative prospective study. The subjects were divided into two categories, i.e., Group A (dextrose, n=50) and Group B (normal saline, n=50). Demographic and clinical factors, such as age, gender, American Society of Anesthesiologists (ASA) status, and BMI, were taken. Demographic factors were further stratified into groups of postoperative outcomes of abdominal pain, nausea, vomiting, and fitness at discharge. The p-value was set at p<0.05.

Results: The average age was 44.3 ± 9 years, and the females constituted 75 % of the participants in the study. There were no differences in age, sex, ASA status, or BMI (p>0.05). The abdominal pain during the postoperative period (20% vs. 52% p=0.001) and nausea (14% vs. 36% p=0.011) were significantly increased in the saline group than the dextrose group. There was no statistically significant difference in vomiting (20% vs. 30%, p=0.248) or discharge fitness (58% vs. 48%, p=0.316). Subgroup analyses revealed significant correlations of both pain and nausea with female sex, status of ASA I, and BMI.

Conclusion: Dextrose intravenous preoperative loading was found to be better than normal saline in reducing postoperative abdominal pain and nausea, which indicated that intravenous dextrose preoperative loading was an inexpensive approach to relieve postoperative pain and nausea after laparoscopic cholecystectomy.