Dexamethasone with either granisetron or ondansetron for postoperative nausea and vomiting in laparoscopic surgery.

Abstract

In a prospective randomized double-blind study, we compared the effectiveness of dexamethasone 8 mg with either granisetron 1 mg or ondansetron 4 mg in the prevention of postoperative nausea and vomiting in patients undergoing laparoscopic surgery. Hundred ASA I and II patients scheduled for laparoscopic surgery were enrolled in the study and 84 patients completed it. Following induction of anesthesia, group I (n=42) received granisetron 1 mg and dexamethasone 8 mg, group II (n=42) received ondansetron 4 mg and dexamethasone 8 mg. Nausea and vomiting episodes, pain scores as well as side effects were recorded during the first hour and subsequently during the first 6 and 24 hours postoperatively. Satisfaction scores were obtained at discharge. There was no statistically significant difference between the 2 groups during the 1st 24 hours following surgery in regards to pain scores, satisfaction and side effects manifestations. At 0-1 hour interval, 100% of patients in group I and 97.6% in group II had no vomiting. Total response (no moderate or severe nausea and no rescue antiemetics) was 83.3% in group I and 80.95% in group II, and metoclopramide was used in 7.1% of patients in both groups. At 1-6 hours interval, 97.6% of patients in group I and 100% in group II had no vomiting. Total response was 92.8% in group I and 90.9% in group II, and metoclopramide was used in 4.76% of patients in group I and 2.38% in group II. At 6-24 hours no vomiting occurred in 97.6% of patients in group I and 100% in group II. Total response was 95.2% in both groups, and metoclopramide was used in 2.38% of patients in both groups. In conclusion, the combination of dexamethasone 8 mg with either granisetron 1 mg or ondansetron 4 mg following induction of anesthesia in patients undergoing laparoscopic surgery showed no statistically significant difference in antiemetic efficacy with minimal side effects and excellent patient satisfaction.

• Authors: Alia S Dabbous, Samar I Jabbour-Khoury, Viviane G Nasr, Adib A Moussa, Reine A Zbeidy, Nabil E Khouzam, Mohamad F El-Khatib, Anis S Baraka
• Journal: Middle East journal of anaesthesiology (Middle East J Anaesthesiol) Vol. 20 Issue 4 Pg. 565-70 (Feb 2010) ISSN: 0544-0440 [Print] Lebanon
• PMID: 20394255 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Antiemetics
• Ondansetron
• Dexamethasone
• Metoclopramide
• Granisetron

Topics

• Adult
• Antiemetics (adverse effects, therapeutic use)
• Dexamethasone (adverse effects, therapeutic use)
• Double-Blind Method
• Drug Therapy, Combination
• Female
• Granisetron (adverse effects, therapeutic use)
• Humans
• Laparoscopy (methods)
• Male
• Metoclopramide (therapeutic use)
• Middle Aged
• Ondansetron (adverse effects, therapeutic use)
• Patient Satisfaction
• Postoperative Nausea and Vomiting (prevention & control)
• Prospective Studies
• Severity of Illness Index
• Treatment Outcome