Comparison of Preoperative Oral Carbohydrate Fluid and Intravenous Crystalloid for Prophylaxis of Postoperative Nausea and Vomiting in Gynaecological Laparoscopic Surgery

Background: Incidence of postoperative nausea and vomiting (PONV) is 20-50% in patients undergoing laparoscopic surgeries, which necessitates prophylaxis. This research aimed to assess the efficacy of a preliminary oral carbohydrate solution compared with intravenous crystalloid fluid for the prevention of postoperative nausea and vomiting (PONV) in patients undergoing gynecological laparoscopic surgery. Material and Methods: Fifty patients aged 18-50 years, ASA I, scheduled for gynaecological laparoscopic surgery, were randomly allocated to two groups. Patients received either 400 ml of oral carbohydrate (CHO group, n=25) or 10 ml/kg of Ringer's lactate I.V. (RL group, n=25) 2 hours before induction of anaesthesia. Postoperatively, patients were observed for PONV, pain, and other symptoms for 24 hours. The unpaired t-test, chi-square test, and ANOVA were used for statistical analysis. A p-value of less than 0.05 was deemed significant. Results: The total incidence of PONV in the CHO group and the RL group was 32% and 52% for 0-2 hours, and 40% and 52% for 0-24 hours, respectively. There was no significant difference in the requirement for rescue antiemetics to treat PONV among the groups. Blood glucose increased significantly at 60 minutes intraoperatively and 6 hours postoperatively relative to the preoperative baseline in each group, but there was no significant intergroup difference. Ketone bodies were detected at significantly higher levels in the urine of the RL group at 12 and 24 hours postoperatively. When comparing patient satisfaction parameters, patients in the CHO group were more satisfied than those in the RL group. Conclusion: Preoperative administration of 12% oral carbohydrate fluid was effective in controlling vomiting in the early postoperative phase, resulting in better overall patient satisfaction. Keywords: Postoperative Nausea and Vomiting (PONV), Gynaecological laparoscopic Surgery, Oral carbohydrate fluid.