Comparison of ondansetron with ondansetron and dexamethasone in prevention of PONV in diagnostic laparoscopy

  • V. Rajeeva
  • N. Bhardwaj
  • Y. K. Batra
  • L. K. Dhaliwal
Reports of Investigation

Abstract

Purpose

To compare the efficacy of ondansetron-dexamethasone combination with ondansetron alone for prevention of postoperative nausea and vomiting (PONV).

Methods

This double blind, randomized study was carried out in 51 female patients, aged 20–40 yr, ASA-1 physical status undergoing gynecological diagnostic laparoscopy. Group 1 (n = 26) received 4mg ondansetroniv and group 2 (n = 25) received a combination of 4 mg ondansetron and 8 mg dexamethasoneiv soon after induction of anesthesia. Postoperatively patients were assessed hourly for four hours and then at 24 hr for nausea, vomiting, pain and post anesthetic discharge score. Vomiting occurring up to two hours was considered early vomiting and from 2–24 hr as delayed vomiting.

Results

The postoperative nausea score was lower in patients receiving a combination of ondansetron and dexamethasone (3.76) than ondansetron alone (4.38) at 0 hr (P < 0.01), 2 hr (P < 0.05) and 24 hr (P < 0.01). In group 1, 38.5% of patients had a nausea score of ≥ 5 (major nausea) compared with only 12% of patients in group 2 (P < 0.025). The overall incidence of vomiting was greater in group 1 (35%) than in group 2 (8%) (P < 0.05). The combination group showed better control of delayed vomiting compared with the ondansetron group (4%vs 35%)(P< 0.0l).

Conclusion

The combination of ondansetron and dexamethasone provides adequate control of PONV with delayed PONV being better controlled than early PONV

Résumé

Objectif

Comparer l’efficacité d’une combinaison d’ondansétron et de dexaméthasone avec l’ondansétron employé seul pour la prévention de nausées et de vomissements postopératoires (NVPO).

Méthode

La présente étude, randomisée et en double aveugle, a été réalisée auprès de 51 patientes, âgées de 20 à 40 ans, d’état physique ASA I qui devaient subir une laparoscopie gynécologique. Le groupe I (n = 26) a reçu 4mg d’ondansétroniv et le groupe 2 (n = 25), une combinaison de 4 mg d’ondansétron et de 8 mg de dexaméthasoneiv peu après l’induction de l’anesthésie. À la suite de l’intervention, on a évalué les nausées, les vomissements, l’échelle de douleur et de congé à chaque heure, pendant quatre heures, et à 24 h. Les vomissements se produisant jusqu’à deux heures après l’intervention étaient considérés comme des vomissements précoces et ceux qui survenaient entre 2 et 24 h, comme des vomissements tardifs.

Résultats

Le score des nausées postopératoires était plus bas chez les patientes qui avaient reçu une combinaison d’ondansétron et de dexaméthasone (3,76) plutôt que de l’ondansétron seulement (4,38) à 0 h (P < 0,01), à 2 h (P < 0,05) et à 24 h (P < 0,01). Dans le groupe 1, 38,5 % des patientes ont présenté un score de nausées 5 (nausées importantes) comparativement à 12 % seulement des patientes dans le groupe 2 (P < 0,025). Lincidence totale de vomissements était plus grande dans le groupe 1 (35 %) que dans le groupe 2 (8 %) (P < 0,05). Le groupe ayant reçu une combinaison de médicaments, comparé au groupe qui a reçu de l’ondansétron, a présenté un meilleur contrôle des vomissements tardifs (4 %vs 35 %) (P < 0,01).

Conclusion

La combinaison d’ondansétron et de dexaméthasone fournit un bon contrôle des NVPO, meilleur pour les NVPO précoces que pour les NVPO tardifs.

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Copyright information

© Canadian Anesthesiologists 1999

Authors and Affiliations

  • V. Rajeeva
    • 1
    • 2
  • N. Bhardwaj
    • 1
    • 2
  • Y. K. Batra
    • 1
    • 2
  • L. K. Dhaliwal
    • 3
  1. 1.Department of AnaesthesiaPost Graduate Institute of Medical Education and ResearchChandigarh
  2. 2.Department of ObstetricsPost Graduate Institute of Medical Education and ResearchChandigarh
  3. 3.Department of GynaecologyPost Graduate Institute of Medical Education and ResearchChandigarh

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