Does the added benefit of ondansetron over dexamethasone, to control post-operative nausea and vomiting, justify the added cost in patients undergoing tonsillectomy and adenotonsillectomy?
OBJECTIVE
To investigate comparative effectiveness of ondansteron and dexamethasone in prophylaxis of PONV in tonsillectomy and adenotonsillectomy patients.


METHODS
The study was conducted at Shifa International Hospital Islamabad from 1st January to 30th June 2009, on 60 patients undergoing tonsillectomy or adenotonsillectomy, with their consent. After consecutive alternate sampling, patients were divided into two groups containing 30 patients each. Ondansteron was given in one group, and Dexamethasone in the other group, as anti emetic, at the time of induction. Episodes of PONV were recorded at three specified intervals, i.e., immediate postoperative, 6 hours after surgery and 12 hours after surgery. Data was entered on a pre-designed performa. The data was analyzed in SPSS Version 13.0.


RESULTS
Ondansteron Group had a mean age of 12.7 +/- 9.54 years (5-36 years). There were 22 (73.3%) males and 8 (26.7%) females. Dexamethasone Group had a mean age of 14.8 +/- 8.4 years (5-35 years) of whom 18 (60.0%) were males and 12 (40.0%) were females. Overall 6 patients who received ondansetron had PONV compared to 7 patients in the dexamethasone group. This difference was statistically insignificant (p > 0.05).


CONCLUSIONS
Dexamethasone was equally effective in controlling PONV in tonsillectomy and adenotonsillectomy patients. The improved benefit of using ondansetron over dexamethasone, on a regular basis, does not justify the added cost.
Rabbani
Mohammad Zafar
MZ
Shifa International Hospital, Islamabad.
Khan
Mohammad Nasir Ayub
MN
Qureshi
Rashid
R
Zubair
Muhammad
M
Pervez
Mohammad Bin
MB
D000234:Adenoids / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000932:Antiemetics / Q000191:economics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003907:Dexamethasone / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D017294:Ondansetron / Q000191:economics / Q000627:therapeutic use*; D013517:Otorhinolaryngologic Surgical Procedures / Q000191:economics*; D010154:Pakistan; D020250:Postoperative Nausea and Vomiting / Q000191:economics / Q000517:prevention & control*; D014068:Tonsillectomy / Q000191:economics; D055815:Young Adult
D000932:Antiemetics; D017294:Ondansetron; D003907:Dexamethasone