scholarly journals Comparison of Propofol Vs Thiopentone in Post Operative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy

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.  

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 29 (01) ◽  
pp. 7-12
Author(s):  
Zerwah Muhammad Qayum ◽  
Aftab Hussain ◽  
Muhammad Akram ◽  
Muhammad Asif Saleem ◽  
Rehana Feroze ◽  
...  

Objective: To compare the efficacy of aprepitant and dexamethasone versus metoclopramide and dexamethasone combination in prevention of post-operative nausea and vomiting in females undergoing laparoscopic cholecystectomy. Study Design: Prospective Comparative study. Setting: Department of Anesthesia, CMH Lahore. Period: October 2019 to April 2020. Material & Methods: A total of 140 female patients planned for laparoscopic cholecystectomy under general anesthesia, of age ranges from 35-65 years and ASA classification I and II were recruited for the study and were divided into two equal groups. In group A (n=70), patients were given oral aprepitant 80 mg with once sip of water one hour prior to induction and dexamethasone 8 mg upon induction. In group M (n=70), patients were given a placebo one hour prior to induction and intravenous metoclopramide 10 mg and dexamethasone 8 mg upon induction. Results: Age range in this study was from 37 to 65 years with mean age of 46.82 ± 7.29 years. The mean age of patients in group A was 45.73 ± 6.77 years and in group M was 47.91 ± 7.66 years with p-value of 0.076. In our study, significant difference was found between the efficacy of two groups of drugs. The efficacy of aprepitant and dexamethasone was found in 62 (88.57%) patients, while with metoclopramide and dexamethasone, it was found in 51 (72.86%) patients with p-value of 0.031. Conclusion: it is concluded that aprepitant and dexamethasone combination has higher efficacy as compared to metoclorpromide and dexamethasone in prevention of post-operative nausea and vomiting in elective laparoscopic cholecystectomy.


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 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.


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]


2019 ◽  
Vol 26 (07) ◽  
pp. 1197-1202
Author(s):  
Hajra Shuja ◽  
Mehmood Ali Shah ◽  
Sadaf Bokhari

Background: Laparoscopic cholecystectomy is a standard treatment for cholelithiasis. It is a safe and effective treatment in many cases. General anesthesia has a high incidence for PONV. But anti-emetic drugs can help in preventing PONV. Objectives: To compare the efficacy of ondansetron and metoclopramide in patients undergoing laparoscopic cholecystectomy under general anesthesia. Study Design: Randomized controlled trial. Setting: Department of Anaesthesia, Sheikh Zayed Hospital, Lahore. Period: 6 months i.e. from 15-2-2017 to 15-8-2017. Material & Methods: The patients were divided into two groups. Ondansetron was given to group A patients within 15 minutes of induction, and metoclopramide to group B patients within 15 minutes of induction. Then patients were shifted to the ward after surgery and followed-up for 24 hours for assessment of PONV. All the data was entered and analyzed on SPSS version 20. Results: The mean age of patients in group A was 38.40±12.07 years and in group B was 42.63±11.77 years. The efficacy achieved in 53 were from group A and 39 were from group B Statistically significant difference was found between the study groups i.e. p-value=0.003. Conclusion: Ondansetron showed significantly better efficacy than metoclopramide in preventing PONV after laparoscopic cholecystectomy under general anesthesia.


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.


2017 ◽  
Vol 24 (07) ◽  
pp. 1062-1066
Author(s):  
Bashir Ahmed ◽  
Hamid Raza ◽  
Kamlaish -

Objectives: The aim of our study which is to compare total intravenousanesthesia with target controlled infusion using the drugs Propofol and remifenatnil with thetechniques of volatile induction maintenance anesthesia using sevoflurane and sufentanil inpatients undergoing laparoscopic cholecystectomy procedure, at a tertiary care hospital inKarachi, Pakistan. Study Design: The type of study is a randomized control trial, conductedfor a period of 8 months Period: from June 2015 to January 2016 Setting: at a tertiary carehospital in Karachi Pakistan. Method: The patient population consisted of n=100 patientsbelonging to the ASA class I and II and undergoing laparoscopic cholecystectomy procedure atour institute. The patients were divided into two groups group A consisted of all those patientswho underwent total intravenous anesthesia and group B consisted of patients who underwentvolatile induction maintenance anesthesia. Appropriate blinding measures were taken for thosewho were involved in the post-operative care of the patients, and the patients themselves. Duringthe procedure routine monitoring was done, data was recorded in a pre-designed proforma.Patients were analyzed in the post-operative period for side effects and pain levels. Statisticalanalysis was done using SPSS version 23, a p value of less than 0.05 was considered to bestatistically significant. Results: The patient population consisted of n= 100 patients dividedinto two groups. No statistically significant difference was found between the demographicvariables of the patients of both groups (age, weight, baseline values of blood pressure, heartrate, time duration of surgery and anesthesia). The time for the loss of corneal reflex was longerin the group A (109 +/- 90) as compared to group B (45 +/- 10) having a p value of less than0.001. However the time for opening of the eyes and the duration of post anesthesia care unitwas shorter in group A (420 +/- 130 seconds for eye opening and 45 +/- 15 min for PACU) andin group B (484 +/- 116 seconds for eye opening and 53 +/- 25 mins for PACU) having p valuesof 0.006 (eye opening) and 0.017 (PACU) respectively. In group A n= 44 (88%) of the patientsrequired rescue analgesia, and in group B n= 36 (72%) of the patients required it, having a pvalue of 0.013 respectively. The need for the use of ephedrine and atropine in the pre and portoperative period was similar in both the groups. Conclusion: According to the results of ourstudy we found that each method of anesthesia has its own advantages and disadvantagesand the anesthetist present should weigh the risks and benefits for each patient individually,and use the most beneficial method of administration of anesthesia in the patient undergoinglaparoscopic cholecystectomy procedure, accordingly.


2020 ◽  
Vol 27 (09) ◽  
pp. 1839-1844
Author(s):  
Ali Arslan Munir ◽  
Abeera Zareen ◽  
Sumbal Rana

Objectives: Comparing the effectiveness of combining ondansetron and dexamethasone vs ondansetron unaided in amounts suggested by SAMBA strategies for stoppage of post-operative nausea and vomiting in laparoscopic cholecystectomy patients. Study Design: Randomized Control trial. Setting: Department of Anaesthesia, Combined Military Hospital, Rawalpindi. Period: Six months (April 2015–October 2015). Material & Methods: A sum of 160 patients were experimented by taking 80 in every group. Group A: of ondansetron. Group B: ondansetron plus dexamethasone. Significance level: 5% Test power: 80% Proportion of the projected population A is 72%1. Foreseen population percentage B is 88%1. Besides successive non-probability specimen system was taken for sample gathering. Patients who were selected were American society of anesthesiologists 1 & 2 while ones with struggle in communiqué e.g. psychologic issues, memory loss, loss of speech etc, pregnant and menstruating ladies3, known of PONV, motion disease, ear problems and vertigo, on long term steroid use3, anguished from diabetes mellitus, hiatal hernia were excluded. The frequency of side effects were duly scribed down and doses of drugs wrote down. Rescue anti vomiting was secondhand for ones of PONV. Results: We deduced that mixture of ondansetron & dexamethasone was effectual in averting post-operative nausea & vomiting equated to Ondansetron unaided. Conclusion: There is variance in incidence of PONV in mutual clusters with combination remedy of ondansetron plus dexamethasone being safer as equated to Ondansetron unaided.


2009 ◽  
Vol 21 (2) ◽  
pp. 67-71
Author(s):  
Montosh Kumar Mondal ◽  
Shahadat Hossain ◽  
Beauty Rani Roy ◽  
Begum Maksuda Farida ◽  
Joysree Roy ◽  
...  

This study was undertaken to find out the efficacy of oral premedication with ondansetron to prevent post-operative nausea and vomiting in diagnostic gynaecological laparoscopy assisted surgery and to compare it with metoclopramide. We studied fifty patients of ASA physical status I & II, aged between 18-30 years and body weight between 50-60 kgs. The patients were randomized in equal numbers into two groups; Group A patients were received Tab Metoclopramide 10 mg orally an hour before operation and regarded as control and Group B patients were received Tab Ondansetron (0.15 mg/kg) or total 8 mg orally an hour before operation as case. They received a standard general anesthetic. Post-operative analgesia was provided with per rectal diclofenac sodium (50mg). In the recovery room occurrences of nausea and vomiting was assessed for 24 hours. The incidence of nausea was 80% in Group-A, 24% in Group-B (p<0.001) and vomiting was 64% in Group-A, 16% in Group-B (p<0.001). The difference among the groups was statistically significant. Key words: Laparoscopy assisted gynaecological surgery, PONV, oral ondansetron, metoclopramide. Journal of BSA, 2008; 21(2): 67-71


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