“A Spoonful of Sugar…”

Yes, it helps the medicine go down, according to the old song. But it turns out that a little sugar – or more properly dextrose in the intravenous fluid – may help to reduce the chance of perioperative nausea and vomiting in surgery patients, and reduces the need for anti-nausea medications.

According to a presentation at the recent American Society of Anesthesiologists 2009 Annual Meeting, in a randomized trial of 56 healthy surgery patients undergoing identical general anesthesia techniques, the group receiving 5% dextrose and Ringer’s Lactate in their IV, rather than plain Ringer’s lactate, had significantly lower nasuea scores 30 minutes after arriving in the PACU and at discharge, and lower overall nausea scores than the control group.

Those in the dextrose group required half the amount of antinausea medications while in the recovery room, and were able to be discharged sooner. (147 vs 178 minutes) The two study groups were otherwise similar for all other relevant factors: age, anxiety level, weight, previous history of perioperative nausea, previous surgery, nothing by mouth (NPO) status, anesthetic time, preoperative glucose, intraoperative nitrous oxide and narcotic use, and total weight-based fluid volume received.

Of all the things about surgery that patients worry about, having nausea or vomiting after surgery is certainly one that’s near the top of the list. This study suggests another easy-to-implement idea. I think this is certainly worth trying for our patients.

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