ABSTRACT
Introduction: Post-operative nausea and vomiting [PONV] is one of the important complications after laparoscopic surgery resulting in patient dissatisfaction and consumption of healthcare resources
Objectives: We compared the efficacy of dexamethasone and ondansetron in preventing post operative nausea and vomiting in gynaecological laparoscopic surgeries
Methods: After approval from ethical committee and informed consent, the patients were randomly assigned to receive dexamethasone 8 mg or ondansetron 4 mg i.v. at induction. Postoperative PONV scores, pain scores, morphine consumption and Richmond Agitation sedation scores were compared one hourly for 6 hours and at 12 and 24 hours
Results: Both patient groups were similar in age, weight, height, duration of surgery and ASA distribution. No difference was observed in PONV scores at 1 hour [p=0.33], 2-3 hours [p=0.27], 4-6 hours [p=0.13] and 7-12 hours [test p=0.48]; first episode of vomiting [4.87 sd +/- 2.29 vs. 4.29 sd +/- 1.32 hours, p=0.59]; maximum pain scores at 1 hour [p=0.61], between 2-3 hours [p=0.32], 4-6 [p=0.47], 7-12 [p=0.57] and 13-24 hours [p=0.79]; and post-operative Richmond Agitation Sedation scores [p =0.33; 0.48, and 0.50 at 1-3, 4-6, and 7-12 hours]. Mean morphine consumption was similar in two groups at 1-3 hours [2.44 +/- 2.18 vs. 3.0 +/- 2.0 mg; p=0.24], 4-6 [3.73 +/- 2.85 vs. 4.41 +/- 2.72 mg; p=0.31], 7-12 [3.81 +/- 2.91 vs. 4.75 +/- 2.96 mg; p=0.18] and 13-24 hours intervals [3.94 +/- 2.97 vs. 4.80 +/- 2.97 mg; p=0.23]. The time to first occurrence of nausea was significantly delayed in dexamethasone group, [3.85 +/- 2.24 vs. 2.25 +/- 1.38 hours; p=0.02]
Conclusion: The efficacy of dexamethasone and ondansetron in preventing post-operative nausea and vomiting in gynaecological laparoscopic procedures is comparable; onset of nausea is significantly delayed in dexamethasone group