1Associate Professor, Dept. of Pharmacology, PMCH, Patna, Bihar
2Assistant Professor, Dept. of Pharmacology, IGIMS, Patna, Bihar
3Tutor, Dept. of Pharmacology, J.M. Medical College and Hospital, Turki, Bihar
4Assistant Professor, Dept. of Pharmacology, AIIMS, Patna, Bihar
5Professor and Head, Dept. of Pharmacology, PMCH, Patna, Bihar
*Corresponding author: Dr. Manish Kumar Assistant Professor, Dept. of Pharmacology, IGIMS, Patna, Mob: -9304093698, Email ID: -manu072@gmail.com
Online published on 16 August, 2018.
This study was designed to compare efficacy of Ondansetron 4mg i.v. as monotherapy with Ondansetron 4mg i.v. plus Dexamethasone 8mg i.v. as a combination therapy given soon after intubation in the prevention of post-operative nausea and vomiting (PONV) in patients undergoing Abdominal Surgery.
This prospective randomized open label comparative study was conducted in Tertiary Care Hospital on 100 patients equally divided into two Groups (Group A and Group B) between 18–45 years of both sexes and ASA (American Society of Anaesthesiologists) I and II posted for Abdominal Surgery under General Anaesthesia. Antiemetic Prophylaxis was given soon after intubation.
Group A-Ondansetron 4mg i.v. (Monotherapy)
Group B-Ondansetron 4mg i.v. plus Dexamethasone 8 mg i.v. (Combination Therapy)
Metoclopramide 10 mg slow IV was rescue antiemetic
Nausea Score using Visual Analogue Scale (VAS) and Vomiting score were recorded after administration of study drugs hourly for 4 hours and then followed up to 24 hours postoperatively. Incidence of PONV within 2 hours was recorded as Early and thereafter up to 24 hours as Delayed.
Incidence of early nausea, delayed nausea, early vomiting and delayed vomiting in Group A and Group B was 58%, 36%, 44%, 38% and 26%, 14%, 22%, 6% respectively. Incidence of PONV was significantly less in combination therapy compared to monotherapy. Difference between both groups was statistically significant. Rescue antiemetic requirement was only in 4% cases of Group B but it was significantly required in Group A cases (in 40%).
Combination therapy was more efficacious in prevention of both early as well as delayed post-operative nausea and vomiting (PONV). Thus, combination therapy may be a reasonable and efficacious approach to reduce incidence and severity of PONV in adult patients undergoing abdominal surgery under general anaesthesia.
PONV, Antiemetics, Ondansetron, Dexamethasone