Abstract

A COMPARATIVE STUDY OF ONDANSETRON WITH DEXAMETHASONE AND GRANISETRON WITH DEXAMETHASONE FOR PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING FOLLOWING ABDOMINAL SURGERIES UNDER GENERAL ANAESTHESIA.

Rakesh Bendre*, Dinesh Karthik, Somasekharam Potli, Ravi Madhusudhana.

ABSTRACT

Aims and Objectives: To compare the effectiveness of Ondansetron with dexamethasone to that of Granisetron with dexamethasone for prevention of post operative nausea and vomiting (PONV) after abdominal surgery under general anaeshesia with respect to nausea, vomiting, requirement of rescue antiemetics and side effects. Materials: With Institutional ethical committee clearance, clinical Study conducted at R.L.J.H, Kolar. After obtaining informed written consent,60 patients of ASA(American Society of Anaesthesiologists) grade I and II in the age group of 18- 55 years of either sex undergoing elective surgeries were included. Methods: Patients were randomly allocated into 2 groups of 30 each.30 patients received Dexamethasone 8mg intravenously just after intubation, 4mg ondansetron intravenously 30min before extubation and 30 patients received Dexamethasone 8mg intravenously just after intubation, 2mg Granisetron intravenously 30min before extubation. PONV occurring up to 3hours was considered early and at 6, 12, 24 hour as delayed. A standard anaesthetic technique was used in all patients. Postoperatively, patients were assessed for episodes of nausea, retching and vomiting and the need for rescue antiemetic. Complete response defined as the absence of nausea, retching or vomiting and no need for rescue antiemetic during the 24-hour observation period. Results: Our report showed that administration of Granisetron 1 mg and Dexamethasone 8 mg or Ondansetron 4 mg and Dexamethasone 8 mg in patients undergoing abdominal surgeries under general anaesthesia, prevented PONV in a high percentage of patients with minimal side effects. We also found during the early post operative period (0-3hrs) only 10% in Group with Granisetron and Dexamethasone had nausea while 26.7% in group with Ondansetron and Dexamethasone had nausea. This was found to be statistically significant (P<0.10). We did not find any statically difference between the two groups when we compared early versus late in terms of rescue antiemetic required and side effects. Conclusion: This study concludes Dexamethasone 8 mg in combination with Granisetron 1 mg or Ondansetron 4 mg was found to prevent nausea and vomiting in a high percentage of patients undergoing abdominal surgeries under general anaesthesia with minimal side effects. During the early post operative period, Granisetron with Dexamethasone is effective in preventing nausea than Ondansetron and Dexamethasone. There was no statistical significance difference between the two combinations concerning rescue antiemetic required or side effects.

Keywords: General anaesthesia; PONV; abdominal surgery; Ondonsetron; Granisetron; Dexamethasone; nausea; retching; vomiting; rescue antiemetic; complete response.