Dexamethasone with either granisetron or ondansetron for postoperative nausea and vomiting in laparoscopic surgery.
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.
Dabbous
Alia S
AS
Department of Anesthesiology, American University of Beirut-Medical Center, Beirut, Lebanon. ad00@aub.edu.lb
Jabbour-Khoury
Samar I
SI
Nasr
Viviane G
VG
Moussa
Adib A
AA
Zbeidy
Reine A
RA
Khouzam
Nabil E
NE
El-Khatib
Mohamad F
MF
Baraka
Anis S
AS
D000328:Adult; D000932:Antiemetics / Q000009:adverse effects / Q000627:therapeutic use*; D003907:Dexamethasone / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D017829:Granisetron / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008787:Metoclopramide / Q000627:therapeutic use; D008875:Middle Aged; D017294:Ondansetron / Q000009:adverse effects / Q000627:therapeutic use; D017060:Patient Satisfaction; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000932:Antiemetics; D003907:Dexamethasone; D017829:Granisetron; D008787:Metoclopramide; D017294:Ondansetron