scholarly journals Dexamethasone is cost-effective alternative to ondansetron in preventing Post-Operative Nausea and Vomiting

2020 ◽  
Vol 24 (1) ◽  
pp. 14-21
Author(s):  
Muhammad Sazzad Hossain ◽  
Md Afzalur Rahman ◽  
Mamunur Rashid ◽  
Mahiuddin Alamgir ◽  
Md Waliullah ◽  
...  
Keyword(s):  
Placebo Group ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Cost Effective ◽  
Nausea And Vomiting ◽  
Dexamethasone Group ◽  
Ent Surgery ◽  
Cost Effective Alternative ◽  
Post Operative Nausea ◽  
Late Postoperative Period

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

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
Keyword(s):  
Postoperative Nausea ◽  
Addis Ababa ◽  
Statistical Significance ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Dexamethasone Group ◽  
Ent Surgery ◽  
Group A ◽  
Group B ◽  
Nose And Throat

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.

scholarly journals A Comparative Study of Single Dose Dexamethasone versus Ondansetron for control of Post Operative Nausea and Vomiting after High-Risk Surgeries

2020 ◽  
Vol 8 (1) ◽  
pp. 64-70
Author(s):  
Ashwin Joginipally ◽  
Nikhil Mudgalkar
Keyword(s):  
High Risk ◽  
General Anesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Age Group ◽  
Dexamethasone Group ◽  
Group I ◽  
Group Ii ◽  
Post Operative Nausea

The occurrence of postoperative nausea and vomiting is generally associated with anesthesia and surgery. The problem is compounded in cases of high-risk surgeries where the incidence is quite high. The present study was designed to compare the efficacy of Dexamethasone and Ondansetron. Methods: This study was undertaken at the Prathima Institute of Medical Sciences, Naganoor, Karimnagar. In this randomized, open clinical trial, we studied 80 ASA grades I to 1V patients of age group 20-60 years undergoing Laparoscopic Laparotomy, Major Gynecological surgeries, Renal, Shoulder and ENT surgeries under general anesthesia. The patients were randomly divided into two groups, Group I and Group II, each consisting of 80 patients. Group I received 4mg dexamethasone intravenous (IV) just after intubation and group II received 4mg Ondansetron intravenous (IV), just before extubation. Results: The most common age group was 50 – 59 years which had n=45(28.1%) patients out of which group I was n=24(15%) patients and n=21(13.1%) patients. The next common age group was 20 – 29 years out of which n=23 (14.4%) and n=18(11.2%). ondansetron group, early nausea is mild in 6.9%, moderate in 3.8%, and severe in 1.2% of patients. Whereas in the dexamethasone group early nausea is mild in 6.2%, moderate in 4.4%, severe in 1.9% of patients. In the ondansetron group, late nausea is mild in 9.4%, moderate in 3.8%, and severe in 0.6% of patients. Whereas in the dexamethasone group late nausea is mild in 7.5%, moderate in 4.4%, severe in 0.6% of patients. In the ondansetron group, early vomiting is mild in 5.0%, moderate in 0.6%, and severe in 0.6% of patients. Whereas in the dexamethasone group early vomiting is mild in 4.4%, moderate in 1.2%, severe in 0.6% of patients. Conclusion: dexamethasone given intravenously just after intubation and ondansetron given intravenously just before extubation are safe and have similar efficacy in postoperative nausea and vomiting after elective surgeries under general anesthesia having a high risk of PONV

A Clinical Comparative Study of Ondansetron, Palonosetron, Ramosetron, and Metoclopramide for Prevention of Postoperative Nausea and Vomiting in Patients undergoing Laparoscopic and ENT Surgery under General Anesthesia

2017 ◽  
Vol 2 (2) ◽  
pp. 65-69
Author(s):  
Gopal Krishan ◽  
Siddhartha Hanjura ◽  
Anil P Agrawal ◽  
Vartika Vinay ◽  
AP Verma ◽  
...  
Keyword(s):  
Comparative Study ◽  
General Anesthesia ◽  
Surgical Procedures ◽  
Postoperative Nausea ◽  
Recovery Period ◽  
Postoperative Nausea And Vomiting ◽  
Cost Effective ◽  
Nausea And Vomiting ◽  
Ent Surgery ◽  
Prolonged Recovery

ABSTRACT Introduction Postoperative nausea and vomiting (PONV) is a well-known entity following surgical procedures and may result in serious complications including aspiration of gastric contents, prolonged recovery period, and impaired surgical wound healing. Laparoscopic surgery is a known risk factor for PONV. Also, the incidence of vomiting after ear nose throat (ENT) surgeries is relatively high. Aims and Objectives Our aim of the study is to compare the effectiveness of ondansetron, palonosetron, ramosetron, and metoclopramide to prevent PONV in patients undergoing laparoscopic and ENT surgery under general anesthesia. Materials and methods The present study was conducted on 120 adult patients scheduled for elective laparoscopic chole­cystectomy and ENT surgery under general anesthesia. All patients were randomized into four groups (O, P, R, and M) with 30 patients each and received injection ondansetron (4 mg), palonosetron (0.075 mg), ramosetron (0.3 mg), and metoclopramide (10 mg) intravenously during premedication. Patients were observed intraoperatively and 24 hours postoperatively for any episodes of nausea and vomiting. All the patients were observed for side effects, such as dizziness, headache, allergic reactions, etc. Conclusion Palonosetron is quite effective in prevention of PONV compared with ramosetron, ondansetron, and metoclopramide given intravenously for various surgical procedures under general anesthesia. Its effectiveness in PONV provides a new cost-effective agent to the present recital of antiemetic drugs. How to cite this article Vinay V, Agrawal AP, Verma AP, Krishan G, Ahmad R, Hanjura S. A Clinical Comparative Study of Ondansetron, Palonosetron, Ramosetron, and Metoclopramide for Prevention of Postoperative Nausea and Vomiting in Patients undergoing Laparoscopic and ENT Surgery under General Anesthesia. Int J Adv Integ Med Sci 2017;2(2):65-69.

scholarly journals Effects of Modification of Pain Protocol on Incidence of Post Operative Nausea and Vomiting

2016 ◽  
Vol 10 (1) ◽  
pp. 505-511 ◽  
Author(s):  
Ran Schwarzkopf ◽  
Nimrod Snir ◽  
Zachary T. Sharfman ◽  
Joseph B. Rinehart ◽  
Michael-David Calderon ◽  
...  
Keyword(s):  
Patient Care ◽  
Postoperative Nausea ◽  
Total Joint Replacement ◽  
Postoperative Nausea And Vomiting ◽  
Improve Patient Care ◽  
Immediate Release ◽  
Nausea And Vomiting ◽  
Pain Scores ◽  
Management Protocol ◽  
Post Operative Nausea

Background: A Perioperative Surgical Home (PSH) care model applies a standardized multidisciplinary approach to patient care using evidence-based medicine to modify and improve protocols. Analysis of patient outcome measures, such as postoperative nausea and vomiting (PONV), allows for refinement of existing protocols to improve patient care. We aim to compare the incidence of PONV in patients who underwent primary total joint arthroplasty before and after modification of our PSH pain protocol. Methods: All total joint replacement PSH (TJR-PSH) patients who underwent primary THA (n=149) or TKA (n=212) in the study period were included. The modified protocol added a single dose of intravenous (IV) ketorolac given in the operating room and oxycodone immediate release orally instead of IV Hydromorphone in the Post Anesthesia Care Unit (PACU). The outcomes were (1) incidence of PONV and (2) average pain score in the PACU. We also examined the effect of primary anesthetic (spinal vs. GA) on these outcomes. The groups were compared using chi-square tests of proportions. Results: The incidence of post-operative nausea in the PACU decreased significantly with the modified protocol (27.4% vs. 38.1%, p=0.0442). There was no difference in PONV based on choice of anesthetic or procedure. Average PACU pain scores did not differ significantly between the two protocols. Conclusion: Simple modifications to TJR-PSH multimodal pain management protocol, with decrease in IV narcotic use, resulted in a lower incidence of postoperative nausea, without compromising average PACU pain scores. This report demonstrates the need for continuous monitoring of PSH pathways and implementation of revisions as needed.

scholarly journals Comparison of the Efficacy of Metoclopramide Versus Dexamethasone for the Prevention of Postoperative Nausea Vomiting during General Anesthesia

2021 ◽  
pp. 163-168
Author(s):  
Sunil Arjan ◽  
Naila Zahoor ◽  
Kenza Nadeem ◽  
Farah Liaquat ◽  
Tariq Hussain Mughal ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Female Ratio ◽  
Post Operative Nausea ◽  
Group D ◽  
Male To Female

Objective:To evaluate the efficacy of Metoclopramide versus Dexamethasone for prevention of postoperative nausea and vomiting during general anesthesia. Study Design:This is a Randomized control trial (RCT) study. Setting: Study carried out at Department of Anaesthesiology, Surgical Intensive Care Unit and Pain Management, Clinic, Dow University of Health Sciences and  Dr. Ruth Pfau  Hospital Karachi, from December 2018 to June 2019. Materials and Methods:110 patients undergoing elective surgeries, who fulfilled the inclusion criteria and gave informed consent were included in the study. They were randomly assigned to either group M or group D, with 55 patients in each group. All patients were then administered either intravenous dexamethasone (8mg) in group D or intravenous metoclopramide (10mg) in group M at the time of induction of anesthesia. The main outcome measure was postoperative nausea and vomiting, at the end of 6th hour postoperatively. The SPSS version 21 was applied to the data. Results: Majority of the patients 66 (60%) were of age 35 years or less. Mean age of the patients was 35.09±11.55 years. There were more females than males, with male to female ratio being 1:1.03. Overall, in patients receiving metoclopramide, 12(21.8%)  had postoperative nausea and vomiting, while in patients who received dexamethasone, only 4 (7.3%) patients had post-operative nausea and vomiting. When comparing two groups, there was statistically significant (p= 0.02) reduced postoperative nausea/vomiting among those patients who had received intravenous dexamethasone. Conclusion: Intravenous dexamethasone is more effective than Metoclopramide in preventing postoperative nausea and vomiting in patients during general anesthesia.

A Review of Ondansatron Versus Other Antiemetics in Postoperative Nausea and Vomiting

2001 ◽  
Vol 2 (2) ◽  
pp. 10-13
Author(s):  
Lynn Sealey
Keyword(s):  
Postoperative Nausea ◽  
Research Study ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Not Given ◽  
Review Of The Literature ◽  
Considerable Cost ◽  
Recovery Unit ◽  
Post Operative Nausea ◽  
Cost Implications

AbstractThe workload of the recovery unit can be considerably increased by patients suffering post operative nausea and vomiting (PONV). The unit can often become blocked by patients too sick to discharge back to the main ward. Via a review of the literature and a small research study in the authors own recovery ward, it was concluded that PONV causes patients to stay in recovery longer. In fact the study reveals of those patients who did not receive an antiemetic perioperatively, 31% suffered PONV and those who had PONV spent 29 minutes longer in recovery.Despite ondansatron being one of the most expensive drugs, it was only successful in 81% of cases. However those people who did receive ondansatron, spent an average of 8 minutes less time in recovery, compared with those who were not given it. These findings potentially have considerable cost implications, relevant in todays current climate of economy saving strategies. These findings and their implications are discussed.

scholarly journals Post operative nausea and vomiting after laparoscopic cholecystectomy: comparison of prophylactic effect of dexamethasone with ondansetron

2014 ◽  
Vol 24 (2) ◽  
pp. 60-64
Author(s):  
M Younus Ali ◽  
Raihan Uddin ◽  
Amirul Islam ◽  
Mustafa Kamal ◽  
SM Rafiqul Islam ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Vital Signs ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Group A ◽  
The Difference ◽  
Prophylactic Use ◽  
Group B ◽  
Post Operative Nausea

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

scholarly journals Addition of Dexamethasone to Prophylactic Granisetron in Children Undergoing Ocular Surgeries – A Randomised Controlled Double-Blind Trial

2021 ◽  
Vol 8 (01) ◽  
pp. 12-16
Author(s):  
Koilada Shiv Kumar ◽  
Rajan Anand ◽  
Debasis Bagchi
Keyword(s):  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Complete Response ◽  
Nausea And Vomiting ◽  
Fisher Exact Test ◽  
Double Blind ◽  
Exact Test ◽  
Paediatric Age ◽  
Randomised Controlled ◽  
Post Operative Nausea

BACKGROUND Postoperative nausea and vomiting are highly prevalent after ophthalmic surgeries in the paediatric age group. In this randomised, double-blind prospective clinical trial, we studied and compared the efficacy of granisetron and combination of granisetron with dexamethasone to prevent postoperative nausea and vomiting after paediatric ocular surgeries. METHODS Sixty paediatric patients (06 - 12 yrs. of age) undergoing elective ocular surgeries were randomly allocated to one of the two groups of 30 patients each. Group (G) received granisetron 40 mcg kg–1 intravenously as a bolus before induction of anaesthesia. Group (G + d) received granisetron 40 mcg kg–1 & dexamethasone 0.1 mg kg–1 intravenously as a bolus before induction. Student t-test, Fisher exact test were used wherever applicable for statistical analysis using SPSS version 15.0. RESULTS A complete response (defined as no post-operative nausea and vomiting and no need for another rescue antiemetic) was achieved in 63.3 % of patients who received granisetron alone and in 96.7 % of patients who received granisetron plus dexamethasone. We found nil difference in complications between the two groups. CONCLUSIONS We found that addition of dexamethasone to granisetron is more effective and beneficial than granisetron alone in preventing postoperative emesis in 1st 24 hours. KEYWORDS Post-Operative Nausea and Vomiting, Anaesthesia, Granisetron, Dexamethasone

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