scholarly journals Effectiveness of Propofol versus Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Ear, Nose, and Throat Surgery in Tikur Anbessa Specialized Hospital and Yekatit 12th Hospital, Addis Ababa, Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Abere Tilahun Bantie ◽  
Wosenyeleh Admasu ◽  
Sintayehu Mulugeta ◽  
Abera Regassa Bacha ◽  
Desalegn Getnet Demsie

Background. Postoperative nausea and vomiting (PONV) remain as common and unpleasant and highly distressful experience following ear, nose, and throat surgery. During ENT surgery, the incidence of PONV could be significantly reduced in patients who receive dexamethasone and propofol as prophylaxis. However, the comparative effectiveness of the two drugs has not been assessed. The aim of this study was to compare the effectiveness of propofol and dexamethasone for prevention of PONV in ear, nose, and throat surgery. Methods. This study was conducted in 80 patients, with ASA I and II, aged 18–65 years, and scheduled for ENT surgery between December 20, 2017, and March 20, 2018. Patients were randomly assigned to Group A and Group B. Immediately after the procedure, Group A patients received single dose of intravenous (IV) dexamethasone (10 mg/kg) and Group B patients were given propofol (0.5 mg/kg, IV), and equal follow-up was employed. The incidence of PONV was noted at 6th, 12th, and 24th hour of drug administration. Independent t-test and Mann–Whitney test were used for comparison of symmetric numerical and asymmetric data between groups, respectively. Categorical data were analyzed with the chi-square test, and p value of < 0.05 was considered as level of significance. Results. The incidences of PONV throughout the 24-hour postoperative period were 35% in the propofol group and 25% in the dexamethasone group. Statistical significance was found in incidence of PONV (0% versus 22.5%) and use of antiemetic (0% versus 5%) between dexamethasone and propofol groups, respectively, at 12–24 hours. Over 24 hours, 5% in dexamethasone group and 12.5% in propofol group developed moderate PONV, while none of the participants felt severe PONV. Conclusions. Dexamethasone was more effective than propofol to prevent PONV with lower requirements of rescue antiemetics.

2020 ◽  
Vol 15 ◽  
Author(s):  
Arash karimi ◽  
Jahanbakhsh Nejadi ◽  
Mahnaz Shamseh ◽  
Nooshin Ronasi ◽  
Mehdi Birjandi

Background: Postoperative nausea and vomiting (PONV) is a common complication associated with the use of anesthesia. Several antiemetics are used to reduce the incidence and severity of PONV. The aim of this study is to investigate the role of dexamethasone and ondansetron to treat PONV in patients undergoing cesarean section (c-section) under spinal anesthesia. Methods: This double-blind clinical trial study was performed on patients who were referred to the operating room of Haji Karim Asali Hospital of Khorramabad for elective cesarean section in 2016-17. Upon meeting the inclusion criteria, patients were allotted into two groups (n=60). Group A received 8mg of dexamethasone and group B received 4mg of ondansetron after spinal anesthesia. The Visual Analog Scale (VAS) questionnaire and Depression-Anxiety-Stress Scale (DASS) questionnaire was used for the analysis. Patients with mild to moderate stress, anxiety, and depression were included in the study. Data were analyzed using SPSS 16 software. Results: There was no difference in the demographic data of the two groups. The mean severity of nausea in group A was significantly higher than in group B. The frequency of vomiting in group A was 20 times higher than group B, which was found to be statistically significant, p = 0.018. Concerning the type of delivery with the frequency of nausea, the results showed that the frequency of nausea in group A was 3.24 times higher than group B, however, this difference was not statistically significant, p = 0.106. Conclusion: Based on the results of this study, ondansetron had a significant effect on the alleviation of postoperative nausea and vomiting, as compared to dexamethasone in c-section surgical candidates.


2014 ◽  
Vol 24 (2) ◽  
pp. 60-64
Author(s):  
M Younus Ali ◽  
Raihan Uddin ◽  
Amirul Islam ◽  
Mustafa Kamal ◽  
SM Rafiqul Islam ◽  
...  

Background Postoperative nausea and vomiting after laparoscopic cholecystectomy under general anaesthesia are an unpleasant,distressing effects. Prophylactic use of dexamethesone reducing this effects. Objective This study was designed to compare of dexamethasone and ondansetron for prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. Methods Sixty patients who underwent laparoscopic cholesystectomy were randomly allocated into two groups. Group A(n=30) patients received 8mg dexamehtasone intravenously and Group B(n=30) patients received 8mg ondansetron intravenously one minute before induction of anaesthesia. All patients received standard general anaesthesia.Perioperative vital signs and postoperative nausea and vomiting were recorded. Results The incidence of nausea was 13.4% in group A, 16.7% in group B(p>0.05) and vomiting was 6.6% in Group A, 13.4% in group B(p>0.05). The difference among the groups was not statistically significant. Conclusion Intravenous dexamethasone was better to ondansetron in prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. DOI: http://dx.doi.org/10.3329/jbsa.v24i2.19803 Journal of Bangladesh Society of Anaesthesiologists 2011; 24(2): 60-64


2021 ◽  
Vol 17 (3) ◽  
pp. 222-226
Author(s):  
Anum Malik ◽  
Arshad Shahani ◽  
Jawad Zahir ◽  
Hassam Zulfiqar ◽  
Tabassum Aziz

Objective: To compare the efficacy of dexamethasone 8mg versus ondansetron 4mg in preventing postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy Methodology: This quasi-experimental study was conducted at the Department of Anaesthesia and Intensive Care, Holy Family Hospital from 29th July 2018 to 28th January 2019.  Anesthesia was induced with propofol (2mg/kg IV) and Atracurium (0.5 mg/kg IV) was given to facilitate tracheal intubation. Nalbuphine (0.2mg/kg) was used as analgesic.Patients were randomly divided into two groups. Patients in Group A received 4mg ondansetron at end of surgery and Group B received 8mg dexamethasone at induction. Results: A total of 90 patients were included according to the inclusion criteria of the study. The mean age (years) in the study was 37.11+10.60 years. Frequency and percentage of nausea (up to 24 hours) among both the groups was 28 (62.2) and 28 (62.2) respectively (p-value = 1.0) while the frequency and percentage of vomiting (within 24 hours after extubation) was 28 (62.2) and 27 (60.0) respectively (p-value = 0.829) Conclusion: The study concluded that there was no significant difference dexamethasone and ondansetron in preventing postoperative nausea and vomiting.


2020 ◽  
Vol 24 (1) ◽  
pp. 14-21
Author(s):  
Muhammad Sazzad Hossain ◽  
Md Afzalur Rahman ◽  
Mamunur Rashid ◽  
Mahiuddin Alamgir ◽  
Md Waliullah ◽  
...  

Background: Postoperative nausea and vomiting (PONV) is a common complication of anesthesia and surgery. Numerous anti-emetics have been studied to prevent and treat PONV. Methods: This study evaluated the antiemetic efficacy, cost-effectiveness and clinical utility of prophylactic dexamethasone and ondansetron compared with placebo in prevention of postoperative nausea and vomiting after ENT surgery in 90 patients. Results: The incidence of PONV was significantly greater in placebo group than dexamethasone group and ondansetron group (p<0.05). The incidence in the dexamethasone group 10% and ondansetron group 26.66% were comparable p>0.05. The incidence of early (0-6 h) PONV was significantly lower in dexamethasone group and ondansetron group than the placebo group (p <0.05). The early incidence was comparable in the dexamethasone (10%) and ondansetrone (13.33%) group( p>0.05). The incidence of PONV in the late postoperative period (6-24 h) was significantly lower in the dexamethasone group (3.33%) than the ondansetron group (23.33%) P<0.05. Conclusion: Both dexamethasone and ondansetron were more effective than placebo in preventing postoperative nausea and vomiting after ENT surgery but dexamethasone was more effective, less expensive and safer than ondansetron, therefore, it may be better substitute for ondansetron. Bangladesh J Otorhinolaryngol; April 2018; 24(1): 14-21


2019 ◽  
Vol 18 (1) ◽  
pp. 23-29
Author(s):  
Bhuwan Raj Kunwar ◽  
Thaneshowr Rijal ◽  
Puja Thapa ◽  
Mallika Rayamajhi ◽  
Biswo Ram Amatya

Introduction: Postoperative Nausea and Vomiting (PONV) is one of the commonest causes of significant morbidity in the patients after laparoscopic cholecystectomy. The purpose of this study was to compare the incidence of PONV when propofol and thiopentone were used as induction agents during laparoscopic cholecystectomy. Methods: A prospective, randomised comparative study was conducted in operation theatre at a tertiary level referral hospital of Nepal. A sample size of 100 ASA I - II patients aged between 18 and 70 years were included and scheduled for elective laparoscopic cholecystectomy. The study population were divided into two groups: Group A (Propofol), n = 50 and Group B (Thiopentone), n = 50. These patients were followed up for the first 24 hours postoperatively for any PONV at 0-6 hrs, 6-12 hrs, 12-24 hrs. Results: Out of the 100 patients, PONV was observed almost similar in both groups. i.e. group A (Propofol) n = 31, (62%) and group B (Thiopentone) n = 26 (52%) with no statistical significance (p value = 0.1998) within the first 24 hours postoperatively in both groups; and no significant difference was observed at the different time intervals viz. at 0-6 hrs (p value 0.262): Group A = 45%; Group B = 40%; 6-12 hrs (p value 0.781): Group A = 17.5%, Group B = 22.5%; 12-24 hrs (p value 1.000) Group A = 0%; Group B = 2.5% when using the Fisher exact test. The mean ages for development of PONV in these two groups were: Group A = 40 years and Group B = 38 years. The p-value was 0.5125 which showed no statistical significance. In our study 76% (n = 38) were females and 24% (n = 12) were males in Group A; while 70% (n = 35) were females and 30% (n = 15) males in Group B. However, there was no statistical difference between the two groups in terms of PONV. Conclusions: The study showed that there was a high incidence of PONV during laparoscopic cholecystectomy. However, there was no significant difference in the incidence of PONV when propofol or thiopentone was used.  


2009 ◽  
Vol 21 (1) ◽  
pp. 43-49
Author(s):  
Md Rafiqul Hasan Khan ◽  
SN Samad Choudhury

Pregnancy & operation both causes anxiety. Excessive anxiety & noncompliance with fasting can increase gastric volume & predispose patients to postoperative nausea & vomiting. Prevention rather than treatment of postoperative nausea and vomiting should be the anesthetist's aim. It was a prospective double blind comparative study of 60 parturient scheduled for elective caesarean section under subarachnoid block to see the effect of anxiolytic drug on per & PONV in LUCS. We have carried out comparative study with alprazolum as anxiolytic agent & compared the action of Ondansetron with Ondansetron +alprazolum. Parturient at term or elective caesarean section included in the study were ASA grade I & II. A total of 60 cards, 30 in each group were prepared by another person who was blind for the study. Every parturient was allowed to draw one card and grouped accordingly. Group A: Inj. Ondansetron (8mg), Group B: Oral alprazolum (0.25mg) +inj. ondansetron (8mg). After 20 minutes of prehydration under all aseptic precaution lumber puncture was performed with 25 gauge Quincke's needle in the L3-L4 or L4-L5 space in sitting position and 0.5% Hyperbaric Bupivacaine 2.5 ml (12.5 mg.) was injected within 10-12 sec. Immediately after administration of spinal anaesthesia fetal heart rate was noted for any changes in pulse rate, blood pressure, rate of respiration, discomfort and occurrence of side effects: shivering, nausea, vomiting was recorded every 2 minute for first 10 minutes, then at 10 minutes interval for remainder of the operation. Per operative monitoring such as ECG, continuous SpO2, non invasive arterial blood pressure was recorded each two minutes interval from time of intrathecal injection up to 10 minutes and then at 10 minutes interval until the end of operation. In the recovery room postoperative analgesia was provided with injection ketorolac tromethamine 30 mg IM on complaining pain and repeated in all patients if necessary. Presence of nausea and vomiting patients were interviewed at one hourly over the first 3 hours then at 3 hourly up to 24 hours postoperative period. Rescue antiemetic of prochlorparazine 10 mg I/M was given if vomiting occurs once, nausea for 10 minutes or at the patient request. Rest other parameters as for example; heart rate, BP, respiration and SpO2 were also recorded at same interval. Patients were carefully observed for any adverse effects like headache, flushing, drowsiness or any other symptoms. In the present study incidence of nausea and vomiting in group-A was one and in group-B was zero. Regarding hemodynamic changes (Pulse, Blood pressure) SpO2, respiratory changes, during operation and 24 hours post operative period in some occasions significant changes were observed (P<0.05) but in other occasions no significant changes occur. No other adverse effect like headache, constipation and flushing during operation and 24 hours postoperative period were observed in this study. In this study we have found that Ondansetron reduces peroperative and postoperative nausea and vomiting. But addition of Alprazolum (an anxiolytic) to Ondansetron, the chance of nausea and vomiting was less.   Journal of BSA, Vol. 21, No. 1, January 2008 43-49


2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Shahnam Sedighmaroufi ◽  
Ali Abbaskhani Davanloo ◽  
Parisa Moradimajd ◽  
Hamidreza Samaee ◽  
Mohammad Lavaie

Background: Postoperative nausea and vomiting (PONV) is still a common complication that occurs frequently at the time of recovery from eye surgery. Objectives: The present study aimed to compare the effect of oral Ondansetron and Ginger on the frequency and severity of postoperative nausea and vomiting in patients undergoing eye surgery. Methods: A total of 148 patients were randomly assigned to Ginger, Ondansetron, and placebo groups. Group A received a Ginger capsule (1,000 mg), group B Ondansetron capsule (16 mg), and group C placebo capsule with 30 ml water, one hour before surgery. The frequency of nausea and vomiting and the severity of nausea were recorded immediately after recovery, 1, 2, and 4 hours after recovery. Also, some side effects following prescription such as headache, stomach ache, dizziness, and cardiac arrhythmias were recorded. Results: Of the 148 participants, 54% were men, and 46% were women. The average age was in group Ginger (36.14 ± 2.17), group Ondansetron (36.24 ± 2.49), and group placebo (36.24 ± 2.20). There was no significant difference in the frequency of vomiting between the three groups immediately after recovery (P = 0.19) and 4 hours after surgery (P = 0.18). However, the frequency of vomiting in Ginger and Ondansetron groups 1 and 2 hours after the surgery was significantly lower than that in the control group (P = 0.003). No significant difference was observed in the severity of nausea between the three groups at certain times (P > 0.05). There was no significant difference in terms of the need for injection antiemetic drugs after surgery (P = 0.2). Conclusions: Ginger and Ondansetron can reduce the frequency of vomiting. However, Ginger was more effective, safer, and less expensive than Ondansetron; therefore, it may be a better substitute for Ondansetron to prevent PONV.


2021 ◽  
pp. 24-25
Author(s):  
Kothari Asit ◽  
Shah Priyal ◽  
Patel Urvi

INTRODUCTION: Post Operative Nausea and Vomiting (PONV) are the most common distressing symptom after LSCS. Antiemetic drugs play an important role to prevent it. Though many drugs have been tried as prophylaxis and treatment of PONV, no drug has been proved signicantly effective and hence, the present study was undertaken to compare the efcacy and safety of IVmetoclopramide and IVOndansetron as prophylaxis for postoperative nausea and vomiting in LSCS under spinal Anaesthesia OBJECTIVES: To study comparison of IV Ondansetron and IV Metoclopramide for prevention of postoperative nausea and vomiting as well as to compare any adverse effect occurrence through drugs in elective LSCS under spinal Anaesthesia. METHODS: It was a prospective study in which 100 patients were selected and randomly allotted into 2 groups, 50 patients in each group, according to inclusion criteria. Group A: Inj. Ondansetron 0.15 mg/kg i.v. Group B: Inj. Metoclopramide 0.25 mg/kg i.v. RESULT: Mean Age, Weight and Duration of surgery are comparable in both the groups without any statistical signicant difference. Incidence of nausea was 12% in group B and there was no incidence of nausea in group A in 30 min after injecting drugs. The incidence of nausea was 14% in group Aand 28% in group B in 45 min after injecting drugs. Incidence of vomiting was 16% in group B and there was no incidence of vomiting in group Ain 30 min after injecting drugs. The incidence of vomiting was 8% in group Aand 22% in group B in 45 min after injecting drugs CONCLUSION: Efcacy and safety of ondansetron is more than metoclopramide for prevention of nausea and vomiting in LSCS under spinal Anaesthesia


2012 ◽  
Vol 1 (1) ◽  
pp. 24-28
Author(s):  
Mehrdad Naderian ◽  
Ehsan Jangholi ◽  
Taraneh Kharaz Tavakol

Introduction: Pharyngeal packs are commonly used to prevent of postoperative nausea and vomiting (PONV) and Sore throat during nasal surgery following tracheal intubation. the aim of this study is evaluation of effectiveness of pharyngeal packing in the prevention of PONV. Materials and methods: This study with random sampling performed on 120 adult patients scheduled for routine nasal surgery referred Boo – Ali hospital in Tehran, Iran from March 2011 to March 2012. the study was approved in the ethical committee of Azad University and written informed consent to participate in the study. All subjects randomly allocated to Group A or Group B to have and not to have pharyngeal packing during surgery, Respectively.The incidence of PONV and sore throat in the recovery room,at 2 and 6 h were recorded by a 100 mm long visual analogue scale (VAS). Data were analysed using non-parametric tests in SPSS 18. Significant difference was set at p<0.05. Results: The average age of patients was 27.6 ± 7.1 years. The average of age in Group A was 29.2 ± 2.8 years and in Group B was 27.4 ± 3.2 years. The difference in throat pain scores in the two groups at each assessment time was statistically significant. The difference in PONV scores were not statistically significant. Conclusion: The usage of pharyngeal packing during nasal surgery leads to decreased incidence of sore throat in experiment group compared with the control group. Also has no effect on the incidence of PONV. [GMJ. 2012;1(1):24-28]


2017 ◽  
Vol 6 (2) ◽  
pp. 15-20
Author(s):  
Muhammad Masud Hasan ◽  
Md Shafiqul Islam ◽  
Anjuman Ara ◽  
Fazilatunnesa ◽  
Md Ashiqur Rahman ◽  
...  

Postoperative nausea and vomiting (PONV) is a major complication in patients who undergo surgery under general anaesthesia. Various drug regimens and antiemetic interventions have been tried from time to time for prevention of PONV but with a variable success rate. The aim of the study is to compare between ondansetron vs Palonocstron for controlling postoperative nausea and vomiting. In this prospective study, 100 patients aged 18-60 years of ASA GRADE-I and II scheduled for undergoing surgery under general anaesthesia after taking informed written consent at a tertiary care hospital, were randomly divided into two groups of 50 each. Group-A was given palonosetron 75 μg and Group-B was given ondansetron 4 mg. At 72 hours, nausea and vomiting were statistically significant between ondansetron and palonosetron groups. Postoperative side-effects such as headache, dizziness and drowsiness were not statistically significant between ondansetron and palonosetron groups. In conclusion, the antiemetic efficacy of palonosetron is similar to that of Ondansetron for preventing PONV during the first 24 hours after patients who undergo surgery under general anaesthesia. But after 72 hours, nausea and vomiting were statistically higher in ondansetron group than palonosetron group. CBMJ 2017 July: Vol. 06 No. 02 P: 15-20


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