There is some, albeit variable, evidence to show that intravenous dextrose administration can decrease the incidence of postoperative nausea and vomiting (PONV). Could the timing of dextrose administration influence success in treating PONV? In the manuscript “The Relationship of Intravenous Dextrose Administration During Emergence from Anesthesia to Postoperative Nausea and Vomiting: A Randomized Controlled Trial,” Dr. Richard L. Applegate II, Department of Anesthesiology, Loma Linda University School of Medicine, Loma Linda, California, and coauthors randomized 162 non-diabetic patients undergoing ambulatory surgery to receive either 250 ml of lactated Ringer’s solution or dextrose 5% in lactated Ringer’s solution over 2 hours starting at the time of surgical closure. An inhalation anesthetic was used for anesthesia maintenance and patients did not receive PONV prophylaxis intraoperatively.
Though blood glucose levels were higher after infusion of the dextrose containing solution, PONV and need for anti-emetic treatment were no different between the study groups. There are fewer published studies that highlight negative results and the authors are to be congratulated for presenting their data. Dextrose administered at the end of surgery does not have any effect on treating PONV. More study is necessary to see if different doses or timing of administration might potentially have an effect.
For a more general discussion about PONV, click on the link to see a summary on PONV at OpenAnesthesia (OA).