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The effects of preoperative rofecoxib, metoclopramide, dexamethasone, and ondansetron on postoperative pain and nausea in patients undergoing elective laparoscopic cholecystectomy

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Abstract

Background

No trial to date has evaluated the combined effect of preoperative Rofecoxib, Metoclopramide, Dexamethasone, and Ondansetron on postoperative pain and nausea in patients undergoing laparoscopic cholecystectomy (LC).

Methods

A prospective randomized double-blinded placebo-controlled trial was conducted on patients undergoing elective LC. The patients in the intervention group received Rofecoxib 25 mg PO. Additionally the study group received Metoclopramide 10 mg and Dexamethasone 4 mg; and Ondansetron 4 mg intravenously. Pain and nausea were rated preoperatively, on arrival at the postanesthesia care unit (PACU), at points until discharge, and at 24 hours.

Results

97 patients were in the control group, and 108 received intervention. The intervention group had a smaller proportion of men (10% vs. 23%; p < 0.015). There were differences in: length of stay (LOS) until discharge criteria met (12.88 vs. 9.85 hours, p = 0.0006), pain rating on arrival to floor (3.55 vs. 2.48, p = 0.003); highest pain rating (4.38 vs. 3.56, p = 0.032), highest nausea rating (2.99 vs. 1.47, p = 0.001), worst nausea since discharge (2.58 vs. 1.26, p = 0.005), and the use of postoperative anti-emetics in women (64% vs. 37.1%, p = 0.001).

Conclusions

The use of this preoperative regimen resulted in decreased LOS, maximum pain, and nausea ratings. Patients in the intervention group required less postoperative anti-emetics.

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Authors and Affiliations

  1. Department of Surgery, David Grant Medical Center, Travis, AFB CA, 94535, USA

    Marc Antonetti & Phiet Bui

  2. Department of Surgery, Hartford Hospital, University of Connecticut, 80 Seymour St., Hartford, CT, 06106, USA

    Orlando Kirton & Judith A. Hudson-Civetta

  3. Department of Research Administration, Hartford Hospital, 80 Seymour St., Hartford, CT, 06106, USA

    Arben Ademi & Ilene Staff

  4. Department of Anesthesia, Hartford Hospital, University of Connecticut, 80 Seymour St., Hartford, CT, 06106, USA

    Richard Lilly

Authors
  1. Marc Antonetti
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  2. Orlando Kirton
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  3. Phiet Bui
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  4. Arben Ademi
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  5. Ilene Staff
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  6. Judith A. Hudson-Civetta
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  7. Richard Lilly
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Correspondence to Marc Antonetti.

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Antonetti, M., Kirton, O., Bui, P. et al. The effects of preoperative rofecoxib, metoclopramide, dexamethasone, and ondansetron on postoperative pain and nausea in patients undergoing elective laparoscopic cholecystectomy. Surg Endosc 21, 1855–1861 (2007). https://doi.org/10.1007/s00464-007-9501-8

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  • DOI: https://doi.org/10.1007/s00464-007-9501-8

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