Effect of perioperative restrictive and liberal fluid regimens on postoperative nausea-vomiting and quality of recovery in laparoscopic cholecystectomy.

BACKGROUND: Postoperative nausea-vomiting (PONV) occurs often after surgery performed under general anesthesia. Liberal fluid treatments are a low-cost and a low side-effect alternative to pharmacological treatment in the prevention of PONV. AIM: To compare the effects of perioperative liberal and restrictive fluid therapy on PONV and recovery after laparoscopic cholecystectomy. METHODS: A total of 160 patients were randomly allocated to two groups: Liberal fluid treatment group (group L), and restrictive fluid treatment group (group R). Three patients were excluded. Ringer's lactate infusion was administered intravenously as follows: 20 mL/kg/hour to group L, and 4 mL/kg/hour to group R. The primary outcomes were PONV incidence 24 hours postoperatively and the quality of recovery-15 scale at 24 hours postoperatively. RESULTS: The incidence of PONV was significantly lower in group L (38.0%) compared with group R (70.5%) (relative risk: 0.54, 95% confidence interval: 0.39-0.74, P < 0.001). The quality of recovery-15 scale scores for overall satisfaction were significantly higher in group L compared with group R [137 (135-141) vs 135 (130-139), P = 0.006]. CONCLUSION: Perioperative liberal fluid therapy reduced the incidence of PONV and improved the quality of postoperative recovery in patients undergoing laparoscopic cholecystectomy.