RESUMEN
Intramuscular tramadol has been shown to reduce gastric acid secretion. We aimed to investigate its role in reducing the gastric acid contents and compared it with ranitidine in patients undergoing elective cesarean sections under general anesthesia. Sixty ASA-II parturients undergoing elective cesarean section were included in a randomixed double-blind study. The patients were randomly allocated to receive either tramadol 100 mg [n=30] or ranitidine 50 mg IM [n=30] 1 hour before general anesthesia. Gastric contents were collected using blind gastric aspiration after induction and at the end of the procedure. The patients receiving tiamadol had a lower, mean gastric fluid pll after induction and before recovery as compared to patients treated with ranitidine [3.5 +/- 1.7 vs. 5.8 +/- 1.5], and the difference was significant [P value=0.001]. A significantly higher proportion of newborns had a lower APGAR at 1 min in tramadol group as compared to ranitidine group [P value= 0.026] Nalbuphine consumption in first 12 hours after operation was reduced in the tramadol group. There was no significant difference in the incidence and severity of nausea, vomiting or any other side effect between the two groups. In comparison with ranitidine, the administration of tramadol in patients undergoing elective cesarean sections under GA resulted in significantly greater volume and acidity of the gastric contents, lower neonatal APGAR at 1 minute, reduced post operative opioid consumption and no change in the frequency of PONY
RESUMEN
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