Administration of large fluid volumes decreases the incidence of postoperative nausea and vomiting as effectively as ondansetron

Abstract

Background: The possibility that large fluid volumes reduce postoperative nausea and vomiting (PONV) remains unclear due to conflicting data. We examined if administering large fluid volumes to high risk patients would decrease the incidence of PONV and compared the results with ondansetron administration.

Methods: Ninety ASA I, II patients who presented for laparoscopic cholecystectomy were randomized to 1 of 3 groups. They received either (group I) 5 ml/kg/hr of Hartmann's solution, (group II) 30 ml/kg/hr of Hartmann's solution or (group III) 4 mg of ondansetron and 5 ml/kg/hr of Hartmann's solution. The incidence of PONV and severity of pain were assessed at 1, 12 and 24 hours postoperatively.

Results: The number of PONV episodes was significantly reduced in group II and III compared to group I during the 1-12 hr postoperative period and for total incidence. However, there was no significant difference between group II and III. There were no differences among groups regarding the severity of pain.

Conclusions: Intraoperative correction of intravascular volume deficits with 30 ml/kg/hr of Hartmann's solution decreases the incidence of PONV as effectively as administration of ondansetron.

Keywords: Fluid; Laparoscopic cholecystectomy; Ondansetron; PONV.