EFFICACY OF ONDANSETRON ALONE VERSUS ONDANSETRON WITH DEXAMETHASONE IN PREVENTING POSTOPERATIVE NAUSEA OR VOMITING IN PATIENTS UNDERGOING ENT SURGERY
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Keywords
Ondansetron, Dexamethasone, Postoperative Nausea, Vomiting, ENT Surgery
Abstract
Background: Postoperative nausea and vomiting (PONV) are common after Ear, Nose, and Throat (ENT) surgeries due to various factors. Addressing PONV effectively is crucial for patient recovery and satisfaction.
Objective: This study compared the efficacy of ondansetron alone versus ondansetron with dexamethasone in preventing PONV in ENT surgery patients.
Methodology: A six-month prospective study enrolled 138 ENT surgery patients, randomly assigning them to receive ondansetron alone (Group A) or ondansetron with dexamethasone (Group B). Efficacy was assessed by nausea and vomiting occurrence within six hours post-surgery.
Results: Group B showed significantly higher efficacy in preventing PONV compared to Group A (Group A: 62.3% vs. Group B: 84%, p=0.004). While nausea occurrence was lower in Group B, vomiting occurrence did not significantly differ between groups. Group B had fewer multiple vomiting episodes, indicating better efficacy.
Conclusion: Combining ondansetron with dexamethasone provides superior PONV prophylaxis in ENT surgery patients compared to ondansetron alone. This highlights the potential for optimizing perioperative care and patient outcomes in ENT surgeries. Further research is needed to validate these findings.
References
2. Ashfaque, M. (1998). Prevention of postoperative nausea and vomiting: a review of causative factors and management. Med Channel, 4, 43-52.
3. Awad, K., Ahmed, H., Abushouk, A. I., Al Nahrawi, S., Elsherbeny, M. Y., Mustafa, S. M., & Attia, A. (2016). Dexamethasone combined with other antiemetics versus single antiemetics for prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy: An updated systematic review and meta-analysis. International Journal of surgery, 36, 152-163.
4. B Sridevi, V. Sreelakshmi, R. Malleswari, & T. Nagaraju. (2015). Post Operative Nausea and Vomiting Prophylaxis: A Comparative Study of Granisetron Alone and Granisetron Plus Dexamethasone After ENT Surgeries. Journal of Evidence Based Medicine and Healthcare, 2, 7853-7860. doi:10.18410/jebmh/2015/1058
5. Bano, F., Zafar, S., Aftab, S., & Haider, S. (2008). Dexamethasone plus ondansetron for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy: a comparison with dexamethasone alone. J Coll Physicians Surg Pak, 18(5), 265-269.
6. Bhattarai, B., Shrestha, S., & Singh, J. (2011). Comparison of ondansetron and combination of ondansetron and dexamethasone as a prophylaxis for postoperative nausea and vomiting in adults undergoing elective laparoscopic surgery. Journal of emergencies, trauma, and shock, 4(2), 168-172.
7. Chitta, P., Mothe, G., Alugolu, M., & Leela, K. S. (2022). Efficacy of ondansetron alone, dexamethasone alone and combination of ondansetron and dexamethasone for PONV for patients undergoing under general anaesthesia. International journal of health sciences, 6(S6), 2346-2360. doi:10.53730/ijhs.v6nS6.10056
8. Chu, C.-C., Hsing, C.-H., Shieh, J.-P., Chien, C.-C., Ho, C.-M., & Wang, J.-J. (2014). The cellular mechanisms of the antiemetic action of dexamethasone and related glucocorticoids against vomiting. European journal of pharmacology, 722, 48-54.
9. Fujii, Y., & Uemura, A. (2002). Dexamethasone for the prevention of nausea and vomiting after dilatation and curettage: a randomized controlled trial. Obstetrics & Gynecology, 99(1), 58-62.
10. Gan, T. J. (2002). Postoperative nausea and vomiting—can it be eliminated? Jama, 287(10), 1233-1236.
11. Henzi, I., Walder, B., & Tramer, M. R. (2000). Dexamethasone for the prevention of postoperative nausea and vomiting: a quantitative systematic review. Anesthesia & Analgesia, 90(1), 186-194.
12. Imam, S. M. (2004). Efficacy of balanced antiemesis for prophylaxsis againt post operative nausea and vomiting [PONV]: comparative study of ondansetron and dexamethasone versus ondansetron alone. PAFMJ-Pakistan Armed Forces Medical Journal, 54(2), 185-190.
13. Murdoch, J. (2022). Postoperative Vomiting and Nausea after ENT Surgery are Reduced by Gastric Decompression. Otolaryngol (Sunnyvale), 12(9). doi:10.4172/2161-119X.1000484
14. Öbrink, E., Jildenstål, P., Oddby, E., & Jakobsson, J. G. (2015). Post-operative nausea and vomiting: update on predicting the probability and ways to minimize its occurrence, with focus on ambulatory surgery. International Journal of surgery, 15, 100-106.
15. Panda, N. B., Bharadwaj, N., Kapoor, P., Chari, P., & Panda, N. K. (2004). Prevention of nausea and vomiting after middle ear surgery: combination of ondansetron and dexamethasone is the right choice. Journal of otolaryngology, 33(2).
16. Pierre, S., & Whelan, R. (2013). Nausea and vomiting after surgery. Continuing Education in Anaesthesia, Critical Care & Pain, 13(1), 28-32.
17. Rajeeva, V., Bhardwaj, N., Batra, Y., & Dhaliwal, L. (1999). Comparison of ondansetron with ondansetron and dexamethasone in prevention of PONV in diagnostic laparoscopy. Canadian Journal of Anesthesia, 46, 40-44.
18. Shaikh, S. I., Nagarekha, D., Hegade, G., & Marutheesh, M. (2016). Postoperative nausea and vomiting: A simple yet complex problem. Anesthesia Essays and Researches, 10(3), 388-396.
19. Shivanna, A. D., Kadni, R. R., Tausif, S. F., & Zachariah, V. K. (2022). Antiemetic Efficacy of Prophylactic Ondansetron Versus Ondansetron with Dexamethasone Combination Therapies in Women Undergoing Breast Surgeries: A Randomized Controlled Trial. Journal of Pharmacology and Pharmacotherapeutics, 13(2), 182-189.
20. Song, J., Park, E., Lee, J., Park, Y., Kang, B., & Shim, Y. (2011). The effect of combining dexamethasone with ondansetron for nausea and vomiting associated with fentanyl‐based intravenous patient‐controlled analgesia. Anaesthesia, 66(4), 263-267.
21. Wang, X.-X., Zhou, Q., Pan, D.-B., Deng, H.-W., Zhou, A.-G., Huang, F.-R., & Guo, H.-J. (2015). Dexamethasone versus ondansetron in the prevention of postoperative nausea and vomiting in patients undergoing laparoscopic surgery: a meta-analysis of randomized controlled trials. BMC anesthesiology, 15, 1-9.
22. Yosief, P., Beraki, G., Mayer, S., Mengistu, M., & Tesfamariam, E. (2022). Incidence and Risk factors of Postoperative Nausea and Vomiting after ENT Surgery. Int J Anesthetic Anesthesiol, 9, 132.
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Umer Rafique
Senior Lecturer, Department of Anesthesia, Sindh Institute of Urology and Transplantation, Karachi
Palwasha Khan Kasi
Senior Medical Officer, Department of Anesthesia, Liaqat National Hospital, Karachi
Shakil Malik
Assisstant Professor, Department of Anaesthesia, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
Vijai Kumar
Assisstant Professor, Department of Anaesthesia, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
Hiranand
Assisstant Professor, Department of Anaesthesia, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
Rajesh Kumar
Senior Lecturer, Department of Anesthesia, Sindh Institute of Urology and Transplantation, Karachi