title: Comparison of Dexamethasone-Dimenhydrinate and Dexamethasone-Ondansetron in Prevention of Nausea and Vomiting in Postoperative Patients.
abstract: BACKGROUND
  Postoperative Nausea and Vomiting is one of the most common problems after implementation of general anesthesia. The incidence can reach 80% in high-risk patients, depending on the type of surgery. In our study, we aimed to compare dexamethasone-dimenhydrinate and dexamethasone-ondansetron combinations in prevention of nausea and vomiting in postoperative patients.
  
  
  METHODS
  Sixty 18-65-year-olds ASAI-II females who underwent rhinoplasty were included in the study. Patients were randomly included in two groups: Dexamethasone-dimenhydrinate group (group DD) and dexamethasone-ondansetron group (group DO). All patients received dexamethasone 8 mg iv after endotracheal intubation. Anesthesia continuation was established with sevoflurane, air-oxygen mixture and remifentanil infusion. At the 30th minute of the operation, group DO received ondansetron 4 mg iv and group DD received dimenhydrinate 1 mg/kg iv. For postoperative analgesia tramadol (1.5 mg/kg) iv, tenoksikam (20 mg) and afterward for postoperative patient-controlled tramadol was used. In the postoperative recovery room, nausea and vomiting were evaluated at the 30th, 60th, 120th minutes and at the end of 24 h. Total amount of tramadol was recorded. All results were statistically evaluated.
  
  
  METHODS
  Demographics and Apfel risk scores of both groups were similar. Surgical operation duration (p = 0.038) and total preoperative remifentanil consumption were higher in group DD (p = 0.006). In group DO, nausea at 30 and 60 min (p = 0.001, p = 0.007), retching at 30 and 60 min (p = 0.002, p = 0.006) were higher than group DD. The additional antiemetic need in group DO was significantly higher at 30 min (p = 0.001). Postoperative analgesic consumption was similar in both groups.
  
  
  RESULTS
  Our study revealed that dexamethasone-dimenhydrinate combination was more effective than dexamethasone-ondansetron in prevention of nausea and vomiting after rhinoplasty operations.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: Department of Anesthesiology and Reanimation, Yeditepe University School of Medicine, Istanbul, Turkey. nurcankizilcik@gmail.com.
authors.forename: Nurcan
authors.identifier: http://orcid.org/0000-0001-8351-4055
authors.initials: N
authors.lastname: Kizilcik
authors.affiliation: Department of Anesthesiology and Reanimation, Yeditepe University School of Medicine, Istanbul, Turkey.
authors.forename: Sevgi
authors.initials: S
authors.lastname: Bilgen
authors.affiliation: Department of Anesthesiology and Reanimation, Yeditepe University School of Medicine, Istanbul, Turkey.
authors.forename: Ferdi
authors.initials: F
authors.lastname: Menda
authors.affiliation: Department of Anesthesiology and Reanimation, Yeditepe University School of Medicine, Istanbul, Turkey.
authors.forename: Hatice
authors.initials: H
authors.lastname: Türe
authors.affiliation: Department of Aesthetic and Plastic Surgery, Yeditepe University School of Medicine, Istanbul, Turkey.
authors.forename: Bilgehan
authors.initials: B
authors.lastname: Aydın
authors.affiliation: Department of Biostatistics, Yeditepe University School of Medicine, Istanbul, Turkey.
authors.forename: Elif Cigdem
authors.initials: EC
authors.lastname: Kaspar
authors.affiliation: Department of Anesthesiology and Reanimation, Yeditepe University School of Medicine, Istanbul, Turkey.
authors.forename: Ozge
authors.initials: O
authors.lastname: Koner
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000009:adverse effects* / Q000379:methods; D003907:Dexamethasone / Q000008:administration & dosage*; D004111:Dimenhydrinate / Q000008:administration & dosage*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017294:Ondansetron / Q000008:administration & dosage*; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy* / Q000517:prevention & control; D011446:Prospective Studies; D012225:Rhinoplasty / Q000379:methods*; D018570:Risk Assessment; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D017294:Ondansetron; D003907:Dexamethasone; D004111:Dimenhydrinate
keywords: Nausea; Rhinoplasty; Vomiting