Comparison of Dexamethasone and Ondansetrone Use in Prevention of Post-operative Nausea and Vomiting

Background: PONV remained the common cause of patient’s discomfort after anaesthesia 30% in all post-surgical patients and 80% in high-risk patients. With other common and serious complications of surgeries vomiting and nausea remained unpleasant trigger for patients who underwent the surgeries that prolongs the hospital stay and also leads to recurrent admissions. Therefore in this study we want to compare the effectiveness of pre-operative single-dose dexamethasone versus ondansetron in reducing post-operative nausea and vomiting after laparoscopic surgeries.

Methods: Patients admitted for laparoscopic procedures at Ziauddin Hospital North site were recruited for this quasi-experimental study. All consecutive patients were assigned to one of the two groups (1 or 2) using computer generated simple randomised numbers and given either of the two treatments: single dose dexamethasone (5-8mg) or ondansetron (4mg). Researcher assessed post-operative nausea and vomiting at thirty minutes, two, four, eight, and twenty-four hours after the procedure. For statistical association the chi-square test and independent t-test were applied. Significant was defined as a P-value of less than 0.05.

Results: The mean age of patients was 42.9±16.6years with mean weight of 62.9±8.8 kilograms. All the operation performed as laparoscopic and common procedure was cholecystectomy (72/98: 73.5%), followed by appendectomy (17/98: 17.3%). Patients with ondansetron had more episodes of vomiting after 30 minutes of laparoscopic surgery. In addition, we discovered a correlation between the two groups' nausea episodes 30 minutes after surgery. After 30 minutes of laparoscopic surgery, patients who took ondansetron reported more nausea episodes.

Conclusion: Prophylactic dexamethasone 8 mg i.v. significantly reduced the incidence of PONV in patients undergoing laparoscopic surgery.