A Meta-Analysis of Dextrose Infusion as Perioperative Strategy on Preventing Postoperative Nausea and Vomiting

  • Rifaldy Nabiel Erisadana Faculty of Medicine University of Jember, Jember, Indonesia
  • Muhamad Rizal Hadi Pratama Faculty of Medicine, University of Jember, Jember, Indonesia
  • Faliqul Bahar Muhammad Faculty of Medicine, University of Jember, Jember, Indonesia
  • Taufiq Gemawan Department of Anaesthesia and Intensive Care, dr. Soebandi General Hospital, Jember, Indonesia
  • Lia Fatmarita Department of Anaesthesia and Intensive Care, dr. Haryoto General Hospital, Lumajang, Indonesia
  • Uli Artha Ekawaty Department of Anaesthesia and Intensive Care, dr. Haryoto General Hospital, Lumajang, Indonesia
  • Syahrul Mubarak Danar Sumantri Department of Anaesthesia and Intensive Care, Siloam General Hospital, Jember, Indonesia
Keywords: Dextrose, PONV, Anaesthesia, Systematic Review, Meta-Analysis

Abstract

Introduction: Dextrose infusion was introduced as a non-pharmacological perioperative strategy to decrease the PONV incidence. However, current published studies reported remain inconsistent and debatable results regarding the efficacy. This research was conducted to improve the evidence-based perioperative strategies of administering dextrose infusion to prevent PONV.

Method: A literature search was conducted for randomized controlled trial studies (RCTs) in patients who administered dextrose infusion compared to other infusion fluid perioperatively. A quantitative analysis using Review Manager 5.4 was performed with a 95% confidence interval that was visualized in the forest plot graph using the fixed-effects or random-effects model based on the heterogeneity.

Results: A total of 18 RCTs studies analyzed demonstrated there were significant differences in composite PONV (RR, 0.66, 95% CI 0.60, 0.74; P < 0.00001; I2=46%), patients with postoperative antiemetic rescue requirements (RR, 0.67, 95% CI 0.53, 0.86; P < 0.001; I2=68%), and postoperative blood glucose levels (SMD, 2.63, 95% CI 1.76, 3.50; P < 00001; I2=97%). However, there were insignificant results in PONV severity (SMD, -0.94, 95% CI -2.20, 0.31; P = 0.14; I2=97%), patients with analgesic requirements (RR, 0.84, 95% CI 0.60, 1.19; P = 0.33; I2=81%), dose of analgesic requirements (SMD, -2.31, 95% CI -5.76, 1.14; P = 0.19; I2=99%), and PACU stay (MD, -24.73, 95% CI -66.07, 16.61; P < 0.24; I2=99%).

Conclusion: This meta-analysis demonstrated that administering dextrose infusion perioperatively prevents both the PONV incidence and postoperative rescue antiemetic requirements, and also increase postoperative blood glucose levels. However, dextrose infusion is not associated with reducing the PONV severity, postoperative analgesic requirements, a dose of postoperative analgesic use, and PACU stay.

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Published
2024-06-30
Section
Review