Effectiveness of Propofol versus Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Ear, Nose, and Throat Surgery in Tikur Anbessa Specialized Hospital and Yekatit 12th Hospital, Addis Ababa, Ethiopia.

Abera Regassa Bacha,Sintayehu Mulugeta,Abere Tilahun Bantie,Desalegn Getnet Demsie,Wosenyeleh Admasu

doi:10.1155/2020/4258137

Abstract

Background Postoperative nausea and vomiting (PONV) remain as common and unpleasant and highly distressful experience following ear, nose, and throat surgery. During ENT surgery, the incidence of PONV could be significantly reduced in patients who receive dexamethasone and propofol as prophylaxis. However, the comparative effectiveness of the two drugs has not been assessed. The aim of this study was to compare the effectiveness of propofol and dexamethasone for prevention of PONV in ear, nose, and throat surgery. Methods This study was conducted in 80 patients, with ASA I and II, aged 18–65 years, and scheduled for ENT surgery between December 20, 2017, and March 20, 2018. Patients were randomly assigned to Group A and Group B. Immediately after the procedure, Group A patients received single dose of intravenous (IV) dexamethasone (10 mg/kg) and Group B patients were given propofol (0.5 mg/kg, IV), and equal follow-up was employed. The incidence of PONV was noted at 6th, 12th, and 24th hour of drug administration. Independent t-test and Mann–Whitney test were used for comparison of symmetric numerical and asymmetric data between groups, respectively. Categorical data were analyzed with the chi-square test, and p value of < 0.05 was considered as level of significance. Results The incidences of PONV throughout the 24-hour postoperative period were 35% in the propofol group and 25% in the dexamethasone group. Statistical significance was found in incidence of PONV (0% versus 22.5%) and use of antiemetic (0% versus 5%) between dexamethasone and propofol groups, respectively, at 12–24 hours. Over 24 hours, 5% in dexamethasone group and 12.5% in propofol group developed moderate PONV, while none of the participants felt severe PONV. Conclusions Dexamethasone was more effective than propofol to prevent PONV with lower requirements of rescue antiemetics.

Highlights

Postoperative nausea and vomiting (PNOV) remain common and distressing complication following ear, nose, and throat (ENT) surgery, especially when no prophylaxis is given [1,2,3,4,5,6].e pathophysiology of PONV is multifactorial; multiple pathways, neurotransmitters, and risk factors are involved
During the overall follow-up, 2.5% of patients in propofol group and 5% patients in dexamethasone group complained of dizziness, whilst 3% of patients in propofol group reported sedation, but there was no hypoxia and difficulty of breathing and 2.5% of participants in the dexamethasone group experienced headache (Figure 4)
The requirement of rescue antiemetic treatment (0% versus 5%, p 0.02) and incidence of PONV (0% versus 22.5%, p ≤ 0.001) were statistically significantly lower compared to patients enrolled in propofol group over the 12th–24th hours (Table 3)

Summary

Introduction

Postoperative nausea and vomiting (PNOV) remain common and distressing complication following ear, nose, and throat (ENT) surgery, especially when no prophylaxis is given [1,2,3,4,5,6].e pathophysiology of PONV is multifactorial; multiple pathways, neurotransmitters, and risk factors are involved. Postoperative nausea and vomiting (PNOV) remain common and distressing complication following ear, nose, and throat (ENT) surgery, especially when no prophylaxis is given [1,2,3,4,5,6]. Postoperative nausea and vomiting (PONV) remain as common and unpleasant and highly distressful experience following ear, nose, and throat surgery. During ENT surgery, the incidence of PONV could be significantly reduced in patients who receive dexamethasone and propofol as prophylaxis. E aim of this study was to compare the effectiveness of propofol and dexamethasone for prevention of PONV in ear, nose, and throat surgery. Statistical significance was found in incidence of PONV (0% versus 22.5%) and use of antiemetic (0% versus 5%) between dexamethasone and propofol groups, respectively, at 12–24 hours. Dexamethasone was more effective than propofol to prevent PONV with lower requirements of rescue antiemetics

Objectives

Methods

Results

Discussion

Conclusion