Indian Journal of Clinical Anaesthesia


Comparison of Ondansetron, Dexamethasone and Ondansetron Plus Dexamethasone For The Prevention of Post-operative Nausea and Vomiting after Laparoscopic Cholecystectomy


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Author Details: Suman Chattopadhyay, Ananya Biswas, SK Samim Ferdows, Dilip Kumar Bhowmik, Swagata Dey, Biswanath Bi

Volume : 3

Issue :

Online ISSN : 2394-4994

Print ISSN : 2394-4781

Article First Page : 455

Article End Page : 459


Abstract

Introduction: Laparoscopic cholecystectomy is associated with an appreciably high rate of postoperative nausea & vomiting (PONV) which is considered as a reason of patient’s delay in discharge and disability aggravation. This study was designed to compare the effectiveness of Ondansetron, Dexamethason and Ondansetron plus Dexamethasone as an antiemetic prophylaxis for preventing PONV in patients after laparoscopic cholecystectomy.
Methods: In this randomised  double blind study, 153 patients of both sexes of ASA I and II aged between 16 to 60 yrs received 4 mg Ondansetron (Group O, n = 50), 8 mg Dexamethason (Group D, n =51) or Ondansetron 4 mg plus Dexamethasone 8 mg (Group OD, n=52) intravenously immediately before induction of anaesthesia. Perioperative care was standardised in all patients. Patient was then observed for 24 hours postoperatively for any episode of PONV and any adverse effects of the study drugs.
Results:  A complete response (defined as no PONV and no need for another antiemetic) was achieved in 62% of the patients receiving Ondansetron, 64.7% of the patient receiving Dexamethasone and in 84.6% of patients receiving Ondansetron plus Dexamethasone (P<0.05). The overall cumulative incidences (0-24 hrs) of PONV were 40% in Ondansetron group, 37.3% in the Dexamethasone group and 15.4% in combination group (P<0.05). No difference in adverse events was observed in between group.
Conclusion: We concluded that combination of Ondansetron plus Dexamethasone is better than each drug alone as an antiemetic prophylaxis against PONV following laparoscopic cholecystectomy.

Keyword:
Laparoscopic cholecystectomy, Prophylactic, Antiemetic, Ondansetron, Dexamethasone, Nausea, Vomiting