en بیهوشی Anesthesia پژوهشي(توصیفی- تحلیلی) Research <b>&nbsp;</b> <span style="font-size: 13.3333px;">Background: PONV affects more than 50% of high-risk patients undergoing laparoscopic cholecystectomy without prophylaxis. Betahistine, a histamine analog with vestibular-modulating properties, has shown promise in reducing PONV in limited prior studies. This trial evaluated the efficacy and safety of preoperative oral betahistine as monotherapy for PONV prevention.</span> <div><span style="font-size: 13.3333px;">Methods: In this prospective, randomized, double-blind, placebo-controlled trial (January 2019&ndash;December 2021), 228 patients (ASA I&ndash;II, aged 20&ndash;60 years) undergoing elective laparoscopic cholecystectomy were randomized to betahistine 8 mg or identical placebo orally 2 hours preoperatively, with no other prophylactic antiemetics. The primary outcome was PONV incidence over 48 hours. Secondary outcomes included nausea severity (VRS 0&ndash;10), vomiting episodes, rescue antiemetic use (Kaplan&ndash;Meier analysis), pain scores, opioid consumption, time to oral intake, hospital discharge, patient satisfaction, and adverse events. Analysis was intention-to-treat.</span></div> <div><span style="font-size: 13.3333px;">Results: PONV occurred in 36/111 patients (32.4%) in the betahistine group versus 63/111 (56.8%) in the placebo group (p < 0.001; relative risk reduction 47.4%; 95% CI 27.1&ndash;56.3%). Nausea severity was significantly lower in the betahistine group at most time points (p < 0.05). Rescue antiemetic use was lower (25.2% vs. 45.9%; p = 0.002), with longer time to first dose (median 7.8 vs. 4.1 hours; log-rank p = 0.008). Betahistine accelerated oral intake (median 6.2 vs. 7.9 hours; p = 0.028), with a trend toward earlier discharge (43.1 vs. 48.6 hours; p = 0.056) and higher satisfaction (8.4 &plusmn; 1.6 vs. 6.9 &plusmn; 2.1; p < 0.001). Mild adverse events (headache and gastric upset) were slightly more frequent with betahistine (7.2% vs. 2.7%; p = 0.121); no serious adverse events occurred.</span></div> <div><span style="font-size: 13.3333px;">Conclusion: Preoperative betahistine 8 mg effectively and safely reduces PONV incidence and severity after laparoscopic cholecystectomy, with benefits in early recovery and patient satisfaction, representing a valuable prophylactic option warranting clinical integration.</span></div> Antiemetic prophylaxis, Betahistine, Laparoscopic cholecystectomy, Postoperative nausea and vomiting, Randomized controlled trial 72 78 http://umj.umsu.ac.ir/browse.php?a_code=A-10-5974-1&slc_lang=en&sid=1 Ebrahim Hassani ehassani87@gmail.com 3700319475328460038773 3700319475328460038773 No Department of Anesthesiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran Roqayieh Neisari dr.neisary@gmail.com 3700319475328460038774 3700319475328460038774 Yes Department of Anesthesiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran Alireza Mahoori ar_mahoori@yahoo.com 3700319475328460038775 3700319475328460038775 No Department of Anesthesiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran