Effect of Pre-Operative Intravenous Dextrose on Pain, Nausea and Vomiting After Laparoscopic Cholecystectomy

Abstract

Background: Postoperative nausea and vomiting (PONV) is a frequent and distressing complication following laparoscopic cholecystectomy, affecting up to 75% of patients and contributing to delayed recovery and patient dissatisfaction. While pharmacologic prophylaxis is standard, adjunctive strategies such as perioperative carbohydrate administration remain incompletely defined despite their physiologic rationale. Objective: To evaluate the effect of perioperative intravenous dextrose on the incidence, severity, and rescue treatment requirements for PONV in patients undergoing elective laparoscopic cholecystectomy. Methods: In this single-center randomized controlled trial, 180 adult patients (ASA I–II, 18–40 years) scheduled for elective laparoscopic cholecystectomy under standardized anesthesia were randomized to receive either 500 mL Ringer’s lactate (Group A) or 500 mL Ringer’s lactate with 5% dextrose (Group B), infused over 30 minutes beginning 30 minutes prior to surgery completion. PONV severity was assessed using the Bellville score at 1, 3, 6, 12, and 24 hours postoperatively. Blood glucose levels were measured at baseline and 30 minutes post-infusion. Results: Group B demonstrated a significantly lower overall PONV incidence (24.4% vs. 80.0%; p<0.001), reduced mean Bellville scores at 3 hours (1.07±0.25 vs. 1.40±0.86; p=0.025), and reduced rescue antiemetic use (8.9% vs. 33.3%; p=0.004). Transient hyperglycemia occurred in Group B but normalized within 24 hours without exceeding 200 mg/dL. Conclusion: Perioperative intravenous dextrose significantly reduces PONV incidence and severity and lowers rescue antiemetic requirements without clinically significant hyperglycemia, supporting its safe and effective role as adjunctive prophylaxis in laparoscopic cholecystectomy.