ABSTRACT
Background: Following surgery and anesthesia, post-operative nausea and vomiting (PONV) are two of the most common side effects. Dexamethasone has been reported to be effective in reducing the incidence of emesis in patients undergoing chemotherapy. Aim: The aim of the study was to compare the effectiveness of granisetron and dexamethasone in combination with ondansetron and dexamethasone in combination for prophylaxis after laparoscopic cholecystectomy. Materials and methods: This is a prospective study on patients undergoing laparoscopic cholecystectomy consisted of 200 patients. 164 patients completed the study. 82 patients in group 1 and 82 patients in group 2. Patients were randomised in two groups, namely group 1 received granisetron and dexamethasone while group 2 received ondansetron and dexamethasone. Results: Out of 200 patients who initially signed the informed consent form, 164 patients (82 in group 1 and 82 in group 2) completed the study. In this study, Granisetron + Dexamethasone was found to be as effective as when compared to ondansetron + Dexamethasone as at 0-1 hour, 100% of patients in group 1 had no vomiting and 97.56% of patients had no vomiting in group 2. Total response was present in 97.56% in group 1 and 95.12% in group 2. The percentage of patients who received metoclopramide was 8.53% in both the groups. At 1-7 hour, 97.56% of patients in group 1 had no vomiting and 100% of patients had no vomiting in group 2. Total response was present in 96.34% in group 1 and 93.90% in group 2. The percentage of patients who received metoclopramide was 4.87% in group 1 and 2.43% in group 2. At 7-24 hour, 97.56% of patients in group 1 had no vomiting and 100% of patients had no vomiting in group 2. Total response was present in 95.12% in group 1 and 95.12% in group 2. The percentage of patients who received metoclopramide was 2.43% T. Uma Maheswara Rao. Dexamethasone combined with other anti-emetics for prophylaxis after laparoscopic cholecystectomy. IAIM, 2016; 3(6): 136-141. Page 137 in both the groups. 4 out of 82 patients complained of dizziness in group 1 and 4 out of 82 patients complained of dizziness in group 2. 6 out of 82 patients complained of headache in group 1 and 6 out of 82 patients complained of headache in group 2 in the post anaesthesia care unit. Pain scores in group 1 were at 0-1 hr was 6±2.4, at 1-7 hour was 5.4±0.7 and at 7-24 hour was 3.5±0.9. Pain scores in group 1 were at 0-1 hr was 7±2.3, at 1-7 hour was 5.9±2.7 and at 7-24 hour was 4.5±0.2. In between the two groups, there was no significant difference in the side effects and pain scores. Conclusion: The combination of dexamethasone with either granisetron or ondansetron after induction of anesthesia in patients undergoing laparoscopic surgery showed no statistically significant difference in antiemetic efficacy with minimal side effects and excellent patient satisfaction.
ABSTRACT
Aim: This study aimed to evaluate the role of cefazolin in prevention of various infections after abdominal wall repair by mesh. Materials and methods: This is a prospective study consisted of 300 patients with various kinds of hernia (inguinal, femoral, bilateral, incisional, umbilical and lumbar hernias who were treated for elective mesh repair in from September 2010 to October 2014. Results: In the present study, 300 patients with different kinds of hernia were selected for elective surgery. Of them 200 patients (66.6%) were males and 100 patients (33.4%) were females with mean age of 50-55 years. Patients were assigned into study group and control group. 180 patients (60%) received prophylactic cefazolin, this group was named as study group and 120 patients (40%) were named as control group and did not receive any prophylactic antibiotics. The mean age of patients in control group was 51.5±13.45 years and that in study group was 53.0±15.75 years which was not significantly different. (p =0.05). 22 patients (18.3%) of 120 control group patients had epigastric hernia, 18 patients (15%) had incisional hernia, 46 patients (38.3) had inguinal hernia, 34 patients (28.3%) had umbilical hernia and all these patients were not given any prophylactic antibiotics. 44 patients (24.4%) of 180 study patients had epigastric hernia, 31 patients (17.2%) had incisional hernia, 85 patients (47.2%) had inguinal hernia and 20 patients (11.1) had umbilical and all these patients were given prophylactic antibiotic. One patient who received rives repair in the study group developed deep surgical site infection which necessitated readmission and partial debridement of the mesh without complete excision. T. Uma Maheswara Rao. The role of prophylactic cefazolin in the prevention of infection after various types of abdominal wall hernia repair with mesh. IAIM, 2016; 3(6): 124-129. Page 125 Conclusion: This study results did not support the use of cephazolin as a prophylactic for various kinds of abdominal wall hernia repair with mesh