INTRODUCTION:
Laparoscopic cholecystectomy (LC) was first reported in Germany (1985) and France (1987) more than 2 decades ago. Although not immediately universally adopted, it has revolutionized the general surgery. Management of biliary tract disease has evolved from the extensive procedure Karl Langenbuch first performed in 1882 with its significant convalescence to a relatively safe and tolerable outpatient procedure today, offering early return to full activity
Postoperative nausea and vomiting (PONV) is a common unpleasant experience. Although improvement of various anesthetics and the identification of patient-anesthesia and surgery-related risk factors for PONV have helped to develop many preventive strategies in recent years, the overall incidence of PONV in the adult population still remains at 20-30%.
The incidence of nausea and vomiting is affected by the type of surgery; for example it is 30% - 65% after cesarean section, 53% - 75% after laparoscopic cholecystectomy, 62% - 80% after middle ear surgery and 40% -70% after tonsillectomy and adenoidectomy
A variety of antiemetic drugs have been used for the prevention of PONV during 0-24 hours after anesthesia with varying degrees of success including traditional antiemetics (e.g. droperidol, metoclopramide, scopalamine, dixyradine, dimenhydrinate, and aprepitant), non-traditional antiemetics (e.g. dexamethasone, propofol, clonidine, midazolam, and lidocaine), and antiserotonins (e.g., ondansetron, granisetron, ramosetron, tropisetron, dolasetron, and ramosetron).
Non-pharmacological techniques include acustimulation, acupressure, and acupuncture. However, the traditional and antiserotoninantiemetics may produce undesirable adverse effects, such as drowsiness, restlessness, dystonic reactions, and extrapyramidal signs.