Comparative Evaluation Of Ondansetron Used Alone And In Combination With Dexamethasone In Prevention Of Post Operative Nausea And Vomiting Following Laparoscopic Cholecystectomy In Females

Abstract

Post operative nausea and vomiting (PONV) continue to be frequent occurrences, even when conventional antiemetics are prophylactically used. In a randomized double blind study, 60 female patients scheduled for elective laparoscopic cholecystectomy under general anaesthesia were divided into 2 groups of 30 patients each and received 4 mgs of Ondansetron (Group I) or a combination of Ondansetron 4 mgs and 4 mgs of dexamethasone (Group II) preoperatively. Patients were observed for 24 hours post operatively and interpretation of symptoms of nausea and vomiting was done according to Gan and Alexander scale (0-2). 70 % of patients in Group II and 43 % patients in Group I did not experience PONV; the difference was statistically significant (p<0.01). 3 patients (10%) in Group II and 10 patients (33%) in Group I required rescue antiemetic medication during the 24 hour study period. The difference was found to be highly significant(p<0.001) The difference in the incidence of PONV between the two groups after 6 hours to 24 hours was highly significant (p<0.001). It was concluded that prophylactic administration of combination of Ondansetron and dexamethasone is effective than Ondansetron when used alone, in reducing in incidence of PONV with prolonged effects.