A Comparative Study of Using Ondansetron with Dexamethasone or Ondansetron with Haloperidol in Prophylaxis against Post-Operative Nausea and Vomiting after Elective Laparoscopic Abdominal Surgeries

Abstract

Abstract Background Laparoscopic surgery is associated with a remarkably high risk of postoperative nausea and vomiting. the reasons for this high rate of PONV include mechanical factors (such as pressure on the stomach and gut caused by the pneumoperitoneum), neural factors (such as vagal reflexes elicited by irritation of parasympathetic nerve endings in the abdomen), and chemical factors (which include speculative considerations regarding a possible influence of CO2 on PONV). Postoperative nausea and vomiting are usually selflimiting but if persistent or severe, can cause medical complications such as dehydration, electrolyte imbalance and delay in patient’s discharge. Objective To compare between the effect of combination of ondansetron with haloperidol and ondansetron with dexamethasone on prophylaxis against postoperative nausea and vomiting in laparoscopic abdominal surgeries. Methods After approval of anaesthesiology department, scientific and ethical committees in Ain Shams University Hospitals, patients were included in the study, and were divided into two groups (n = 25; each); group A (the ondansetron plus dexamethasone group) and Group B (the ondansetron plus haloperidol group). Results The two groups were adequately monitored and assessed post-operatively and they were compared regarding post-operative nausea and vomiting outcome by recording the incidence of nausea and vomiting and recording the call for rescue antiemetic. Demographic data, intra-operative hemodynamics and post-operative pain score, occurrence of side effects, sedation score and patient satisfaction scores were also assessed. Conclusion The combination of ondansetron with haloperidol is as effective as the combination of ondansetron with dexamethasone in reducing the incidence of nausea and vomiting in post-operative period of laparoscopic abdominal surgeries.