Comparison of the efficacy of ondansetron versus ondansetron and dexamethasone in the prevention/ reduction of post-operative nausea & vomiting after elective surgeries under general anaesthesia

Kiran A. V., Praveen Panchaksh

Abstract

Post Operative Nausea & Vomiting (PONV) has been recognized as one of the major complication after elective surgeries under general anesthesia. The incidence of PONV can be as frequent as 70% to 80% in high risk groups, so prevention or reduction of PONV remains one of the major goals to be achieved. The objective of this study is to compare the efficacy of intravenous ondansetron versus intravenous ondanstetron plus dexamethasone combination in prevention / reduction of PONV after elective surgeries under general anesthesia with respect to early and delayed vomiting and their side effects. Our study was done in 200 patients, randomly divided into 2 groups of 100 patients each. One group received intravenous ondansetron 4mg while the other group received intravenous ondansetron 4mg plus dexamethasone 8mg 30 seconds before induction. Postoperatively patients were assessed hourly for 4 hours and then at 24 hours for degree of nausea, retching and vomiting, requirement of rescue antiemetic and side effects. Vomiting occurring upto 4 hours was considered as early and from 4-24 hours as delayed vomiting. Incidence of early and delayed nausea (20% each) was less in the combination group compared to ondansetron alone (59% and 42% respectively). Delayed vomiting was lower in the combination group (3%) compared to ondansetron alone (36%). We hereby conclude that combination therapy of ondansetron and dexamethasone is superior in controlling post operative nausea and vomiting compared to ondansetron alone.

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