scholarly journals Comparing effectiveness of Metoclopramide alone versus its combination with Dexamethasone for prevention of postoperative nausea and vomiting after thyroidectomy at Menelik II Hospital, Addis Ababa, Ethiopia: a prospective cohort study

2019 ◽  
Author(s):  
Tamiru Tilahun ◽  
Adugna Aregawi ◽  
Temesgen Bati Gelgelu

Abstract Background Postoperative nausea and vomiting (PONV) is a common post- operative unpleasant experience and also common following thyroidectomy that may cause for hematoma and post-operative airway obstruction. Several agents have been tried to reduce severity and incidence PONV.This study intended to compare effectiveness of Metoclopramide alone and its combination with Dexamethasone for prevention of PONV after thyroidectomy at Menelik II Hospital.Methods Prospective cohort study was conducted on 76 American Society of Anesthesiologist (ASA) class I and II, adult patients undergone thyroidectomy. A systematic random sampling was applied to identify sample population through skip interval till required sample size was achieved. Study participants were grouped as Group = M (Metoclopramide alone) and Group = MD (Metoclopramide plus Dexamethasone).Following study participant received either 10 mg Metoclopramide or 5mg Metoclopramide plus 4mg Dexamethasone, PONV was recorded at 6, 12 and 24 hours post operatively. Continuous variables were expressed as mean ± SD or median-IQR as appropriate. Analysis was done by independent two sample t test, Manny Whitney U test and χ2 or fisher exact test. P-Value <0.05 was considered as statistically significant.Results The overall incidence of PONV with in the first 24 hours was significantly higher in Group M as compared to Group MD, 24(63.15%) versus 9 (23.68%) respectively with a P-value of < .01. Although difference was insignificant, severity of nausea at 6th, 12th and 24th was still higher in Group M. From side effects, Sedation was significantly lower in Group MD 6 (15.79%) versus 15 (39.47%) with a P-value of <.05. Despite difference was insignificant headache was found higher in Group M 10 (26.31) vs. 6 (10.52) respectively.Conclusions 5mg Metoclopramide combined with 4mg Dexamethasone has significant effects for prophylaxis of post-operative nausea and vomiting after thyroidectomy. Some side effects of drugs were also significantly reduced in combination group.

2021 ◽  
pp. 72-74
Author(s):  
Anusha K ◽  
Sherin bright

BACKGROUND : Palonosetron is a new potent 5-hydroxytryptamine 3 antagonist. Although used for chemo induced emesis, data is lacking for PONV. The high incidence of nausea and vomiting after breast surgery is well documented. This study compared the effects of i.v.ondansetron and palonosetron administered at the time of induction for preventing postoperative nausea and vomiting (PONV) in these high-risk patients . The aim was to compare Onda METHODS : nsetron 8 mg and Palonosetron 0.075mg administered intravenously for prevention of post operative nausea and vomiting in patients undergoing modied radical mastectomy 24 hours postoperatively, by a randomised , controlled, double blind study. 70 female non smoking patients scheduled for elective modied radical mastectomy were, allocated randomly into 2 groups . Patients received either Palonosetron 0.075mg (GROUP P ) or ondansetron 8mg ( GROUP O ) intravenously, immediately before induction of general anaesthesia. The occurence of nausea, vomiting, retching, need for rescue antiemetics and side effects were monitored for a period of 24 hours after surgery. The compete response rate and overall PONV for 0 - 24 hours were calculated. The demographic prole of the patients were comparable. The RESULTS : incidence of a complete response (no PONV, no rescue antiemetics ) during 0 - 24 hours in post operative period was signicantly high in GROUP P ( 85.7% vs 62.9%, p=0.02) than GROUP O. The incidence of nausea was signicantly low in GROUP P ( 14.3% vs 37.1%). There was no statistically signicant difference between the 2 groups in vomiting, retching, side effects and need for rescue antiemetics. Thus overall PONV was low in GROUP P (14.3% vs 37.1% p = 0.02 statistically signicant.) We conclude that Palonosetron 0.075mg was more effective for preventing PONV in patients undergoing modied radical mastectomy surgery


2017 ◽  
Vol 8 (3) ◽  
pp. 382
Author(s):  
El Rahmayati ◽  
Anggi Irawan ◽  
Tumiur Sormin

<p class="Normal1">Postoperative Nausea and vomiting (PONV) is a common complication after surgery.The incidence of postoperative nausea vomiting is approximately 30% of all patients undergoing inpatient surgery and 70% of cases occur within the first 24 hours. One of nausea and vomiting treatment is non-pharmacological therapies with complementary acupressure therapy. Furthermore, the research was conducted to determine the effect of acupressure complementary therapies against postoperative nausea and vomiting.The research was Quasi-Experimental research design Non-equivalent Control Group, the sampling technique used purposive sampling technique. Based on results of sample calculation used amounted to 22 respondents, consisting of 11 experimental groups and 11 control groups. Collecting data was used questionnaire and analyzed using univariate and bivariate analysis by Wilcoxon and Mann-Whitney with α values (&lt;0.05).The results showed the difference in score of nausea and vomiting the first and second measurements in the control group given a placebo action is 0.91 with a p-value (0.26). Nausea and vomiting difference in scores obtained before and after acupressure complementary therapies in the experimental group was 2:18 with a p-value (0.004). As well as the difference in scores obtained post-operative nausea and vomiting in the control group and the experiment is 1:27 with the p-value (0.009). The above statistical test results can be concluded that there was the effect of complementary acupressure therapy on postoperative nausea vomiting. Based on the conclusion of the research, the authors suggest that complementary acupressure therapy can be applied as a companion therapy and it is expected that nursing staff can learn complementary acupressure therapy.</p>


2020 ◽  
Author(s):  
Mohammed Suleiman Obsa ◽  
Dinkisisa Chemeda Edosa ◽  
Zemenu Muluken Desalegn ◽  
Nega Desalegn Fanta ◽  
Sintayehu Mulugeta Tamiru ◽  
...  

Abstract Background Post-operative nausea and vomiting is the most frequent side effect of anesthesia. It affects 20 - 30% of all post-operative and 70%-80% high risk patients. Consequently, it is one of the most frequently observed adverse events associated with the provision of anesthesia. Thus this study is aimed to assess the incidence and associated factors of post-operative nausea and vomiting. Methods This cross-sectional study was conducted using a consecutive sampling method. Regular supervision and follow up were made. Data was entered in to Epi info version 7 software and transported to SPSS version 20 for analysis. Odd ratio and 95% confidence interval was computed. The findings of the study were reported using tables, figures and narration. Variables that were found to be candidate (p value < 0.25) on binary logistic regression entered into a multiple logistic regression analysis to identify independent predictors of post-operative nausea and vomiting. Results The results of this study indicated that the incidence of postoperative nausea and vomiting was 27.4% . Output of multiple logistic regression revealed that female sex (AOR = 4.065 (2.090 - 7.906), history of motion sickness (AOR = 2.836 (1.582 - 5.083), Gynecologic type of surgery (AOR = 3.782 (1.156 - 12.373), long duration of anaesthesia (> 60 min) (AOR = 2.974 (1.491 - 5.933) and administration of post-operative opioids (AOR = 2.333 (1.221 - 4.457) were considered as independent predictors of postoperative nausea and vomiting at P value < 0.05. Conclusion The present finding has shown that the overall incidence of postoperative nausea and vomiting is high 27.4% therefore provision of anti-emetic prophylaxis is reccomended.


Author(s):  
Suchismita Naik ◽  
Shweta Kujur ◽  
Miltan Debbarma ◽  
Miltan Debbarma ◽  
Madhumita G. Murthy

Background: Postoperative nausea and vomiting (PONV) is common complication after general anesthesia and surgery. This randomized double-blind study was designed to compare the effects of acupressure wrist bands and palonosetron for the prevention of post-operative nausea and vomiting (PONV) in laparoscopic cholecystectomy under general anaesthesia.Methods: Sixty ASA I and II patients undergoing elective laparoscopic surgeries under general anaesthesia were divided into two groups. In Group A patients, acupressure wrist bands were applied on p6 point on both hands half an hour before induction. Group P patients received inj. palonosetron 0.075 m.g. i.v. just before induction. Anaesthesia technique was standardized. Post-operatively patients were monitored for nausea, retching or vomiting upto 24 hours. If patients vomited more than once, they were given inj. Metoclopramide 10mg as rescue antiemetic. Efficacy of drugs was compared using Chi square test. ‘p’ value of <0.05 is considered significant.Results: The incidence of PONV and requirement of rescue antiemetic were lower in palonosetron group than acupressure wrist band group.Conclusions: Palonosetron is more effective than acupressure wrist band for prophylaxis of post- operative nausea and vomiting in the patients undergoing laparoscopic cholecystectomy under general anaesthesia, but acupressure wrist band can also be used as an alternative non-pharmacological method.


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