To Compare the Efficacy of Ondansetron & Dexamethasone Alone and Ondansetron plus Dexamethasone in Combination for Prevention of Post-Operative Nausea and Vomiting In Laparoscopic Surgeries
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 12
Abstract
Abstract: Post-operative nausea and vomiting is one of the commonest & most unpleasant complaint following laparoscopic surgeries. It can lead to several emergencies like wound dehiscence, bleeding, aspiration of gastric contents, delayed hospital discharge, unexpected hospital admission and dissatisfaction among patients. This study is intended to compare the efficacy of ondansetron and dexamethasone alone and combinations of dexamethasone plus ondansetron in patients undergoing laparoscopic surgeries, with respect to nausea, vomiting and requirement of rescue anti-emetics. We studied 150patients between age group of 20yr to 50yr of ASA I & II requiring general anesthesia for laparoscopic surgeries, in a randomized clinical trial. 50 patients received 4mg ondansetron, intravenously and another 50 patients received dexamethasone 8mg intravenously and 50 patients received 4mg ondensetron+8mg dexamethasone 10min before induction, post operatively patients were assessed at time interval of 0-6hours and then at 6-24 hours for degree of nausea, vomiting and requirement of antiemetic drug. Vomiting occurring upto 0-6 hours was considered early vomiting and from 6-24 hour as delayed vomiting. Nausea was lower in the combination group OD (6%) when compared to group O of ondansetron (20%) and group D dexamethasone (12%). Incidence of vomiting was also less in combination group OD (4%) when compared to group O Ondansetron (12%) and group D dexamethasone (16%).The need for the antiemetic drug in groups O, D, and OD was 26, 20, and 6 respectively. The incidence of vomiting and failure in prophylaxis was observed in D-group during the first six hrs. The highest need for the anti-vomiting drug within the 6 to 24 hours of post operation was observed in group O compared to the group OD. We conclude that the combination therapy of ondansetron and dexamethasone provides adequate control of PONV, with delayed PONV being better controlled than early PONV (compare to ondansetron and dexamethasone alone) and the requirement of adjunct anti-emetics is dramatically reduced in first 24 hour.
Authors and Affiliations
Dr. Shakti Singhal, Dr. Gunjan Agarwal, Dr. Ghanshyam Das Singhal
Keywords
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