Effect of dexamethasone combined with intraoperative gastrointestinal decompression on postoperative nausea and vomiting in patients undergoing cholecystectomy with Baska laryngeal mask airway positive pressure ventilation

Wang Tao; Hu Xianrong; Kou Sen; Yan Zijun; Zhang Bangjian

doi:10.3760/j.issn.1673-4777.2025.08.009

Abstract：Objective To investigate the effect of dexamethasone combined with intraoperative gastroin-testinal decompression on postoperative nausea and vomiting in patients with Baska laryngeal mask airway positive pressure ventilation.Methods A total of 240 patients undergoing laparoscopic cholecystectomy with Baska laryn-geal mask positive pressure ventilation in Panzhihua Central Hospital,Sichuan Province from December 2023 to June 2024 were selected.They were randomly divided into blank control group(group A),dexamethasone group(group B),gastrointestinal decompression group(group C)and dexamethasone combined with gastrointestinal decompression group(group D),with 60 cases in each group.Before anesthesia induction,dexamethasone 4 mg was injected intravenously in group B and D.after laryngeal mask implantation,sputum suction tubes were placed in group C and D for gastrointestinal decompression.The areas of gastric antrum were measured and calculated by ultrasound before anesthesia induction(T0),after successful laryngeal mask implantation(T1),and after removal of laryngeal mask(T2).The general information and anesthesia operation,the changes of antral area at T0,T1,and T2,and the occurrence of flatulence,nausea,vomiting,sore throat,and hoarseness at 1,6,and 24 h after operation were observed and compared among the four groups.Results There were no statistically significant differences in general information,operation conditions,and antral areas at T0 and T1 among the four groups(all P＞0.05).At T2,the areas of gastric antrum in group A and B were significantly larger than those in group C and D.The incidences of flatulence,nausea and vomiting at 1 and 6 h after operation and the incidence of nausea at 24 h after operation were significantly different among the four groups(all P＜0.05).The incidences of nausea and vomiting at 1 and 6 h after surgery,gastric distension at 6 h after surgery[1 h after surgery:15.0％(9/60)vs 36.7％(22/60),10.0％(6/60)vs 30.0％(18/60);6 h after surgery:10.0％(6/60)vs 51.7％(31/60),8.3％(5/60)vs 51.7％(31/60)],and nausea at 24 h after surgery[6.7％(4/60)vs 26.7％(16/60)]in Group D were all lower than those in Group A(all P＜0.05).Conclusion Dexamethasone combined with intraoperative gastrointestinal decompression can reduce the incidence of nausea and vomiting at 1 and 6 h after Baska laryngeal mask airway positive pressure ventilation,gastric bloating at 6 h after surgery,and nausea at 24 h after surgery.