Comparative Study of Effect of Dexamethasone with Ondansetron V/S Dexamethasone with Granisetron In Reducing Post Op Nausea Vomiting Incidence In Laparoscopic Gynaecological Surgery.
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Keywords
General anaesthesia, Laproscopic surgery, post-operative nausea vomiting
Abstract
Background: Post-operative nausea and vomiting (PONV) is generally self-limiting, associated with high level of patient dissatisfaction and may delay hospital discharge. With this issue we aim to compare the effectiveness of dexamethasone with granisetron or ondansetron in patients undergoing laparoscopic gynaecological surgery.
Methods: 144 patients were registered in this prospective, randomized double blind study. Study conducted in Santokba Durlabhji Memorial Hospital, Jaipur, Rajasthan. Group I (n=72) received ondansetron 4 mg intravenously (IV)+dexamethasone 8mg (IV) and Group II (n=72) received granisetron 1 mg IV+dexamethasone 8 mg IV prior to induction. Post-operative data of PONV was recorded at pre-defined intervals. During the study period from February 2018 to July 2020.
Results: The majority of the patients were of the age group 20-35 years. The mean score of Group I subjects was 22.10±1.762 and that of Group II was 22.00±1.601 (p=0.741). There are 4.16% of patients in group-I having vomiting episodes, and 2.77% of patients in group-II having vomiting episodes, none of the patients developed 2nd episodes of vomiting in either group. Thus, it appears that dexamethasone in combination with granisetron is more effective in decreasing incidence of PONV than dexamethasone with Ondansetron. Haemodynamic variables showed no significant difference recorded in postoperative care unit between the study groups.
Conclusions: Dexamethasone 8 mg with granisetron 1 mg has more anti emetic efficacy with minimal side effects and excellent patient satisfaction than dexamethasone 8mg with ondansetron 4 mg.
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Dr Nikita Verma
Senior Resident, Hospital - Chhindwara Institute of Medical Sciences, Chhindwara (M.P)
Dr. V.K Parashar
Honorary Consultant, Department of Anaestheriology Critical Care ,Santokba Durlabhji Memorial Hospital Cum Medical Research Institute, Jaipur, Rajasthan