COMPARISON OF ONDANSETRON AND ONDANSETRON PLUS DEXAMETHASONE FOR PREVENTING POSTOPERATIVE NAUSEAAND VOMITING IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

Background and Aims: Postoperative nausea and vomiting (PONV), the most common and distressing symptoms experienced by patients after laparoscopic cholecystectomy often need prophylactic antiemetic therapy. Multimodal prophylactic antiemetic therapy is found to be more effective than any single antiemetic drug. The primary objective of the study was to compare efcacy of ondansetron and ondansetron plus dexamethasone for preventing PONV in patients undergoing laparoscopic cholecystectomy. Material and Methods:Aprospective, randomized, comparative, double blinded study was carried out on 60 ASA Grade I and II patients of either sex aging 26-60 years undergoing laparoscopic cholecystectomy under general anaesthesia. Patients were divided into 2 groups of 30 each by systemic randomization method. Group O: received Ondansetron 4 mg IV, and Group OD: received Ondansetron 4 mg plus Dexamethasone 8mg IV, 10 min before induction of anaesthesia. PONV was assessed immediately after surgery and at 30-min intervals for 2 hours in the recovery room and then in the ward at 6, 12 and 24 hours postsurgery. The occurrence of nausea and vomiting was evaluated on a 3-point ordinal scale. 0 = no nausea or vomiting, 1 = nausea only, 2 = retching and / or vomiting. The primary end point was a “complete response”, dened as no episode of PONV during the rst 24 hrs after recovery from anaesthesia. Failure of prophylaxis was considered as a need for rescue antiemetic. Results: 13 (43.33%) and 22 (73.33%) patients from Group O and Group OD respectively had complete response (p=0.018). 17 (56.66%) patients in Group O and 8 (26.66%) patients in Group OD, who had episode of PONV, 12 and 5 patients respectively needed rescue antiemetic (p>0.05). The duration of hospital stay was longer in Group O than Group OD (p<0.05). Conclusion: In patients undergoing laparoscopic cholecystectomy, prevention of postoperative nausea and vomiting is better with combination of ondansetron plus dexamethasone than ondansetron alone.