Cholelithiasis (presence of gallbladder stones) is prevalent in 10 to 15% of the world
population. This disease can lead to serious complications such as cholecystitis, cholangitis
and pancreatitis. Video-laparoscopic cholecystectomy (CVL) is considered the gold standard
treatment of this condition.
Despite ongoing research and development of new drugs and techniques, postoperative nausea
and vomiting (PONV) are frequent, lead to unexpected hospitalizations, delay hospital
discharge, increase hospital costs, and cause patient dissatisfaction. Video-laparoscopic
surgeries are cited in the literature as a risk factor for PONV, with an incidence of up to
75% in cases where prophylactic drugs are not used.Through the simplified Apfel score, it is
possible to determine the risk for PONV. This risk classification is based on four risk
factors: female gender, non-smoking, postoperative use of opioids and previous history of
PONV. The incidence of PONV would be 10%, 20%, 40%, 60% and 80%, respectively, if none, one,
two, three or four risk factors are present.
Antiemetics recommended for prophylaxis of PONV in adults include 5-hydroxytryptamine (5-HT3)
receptor antagonists (ondansetron, dolasetron, granisetron, tropisetron, ramosetron and
palonosetron), neurokinin-1 (NK-1) receptor antagonists (aprepitant), (dendrohydrin and
haloperidol), antihistamines (dimenhydrin and meclizine), and anticholinergics (scopolamine).