Randomized Double-blind Comparison Of Two Different Low Doses Of Ondansetron in combination with Dexamethasone For Prophylaxis Of Postoperative Nausea and Vomiting in Middle Ear Surgery.

Document Type : Original Article

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Department of Anaesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital.

10.21608/asja.2024.251052.1023

Abstract

BACKGROUND :
Ondansetron is associated with more side effects and is expensive when compared to dexamethasone; thus, mandating a need to identify the optimal dose of 5- HT3 antagonist like ondansetron when used in combination with dexamethasone for PONV prophylaxis. The present study was undertaken with the aim to assess and compare the efficacy of two low-doses of ondansetron i.e. 50 µg/kg and 25µg/kg in combination with 8 mg dexamethasone for prophylaxis of postoperative nausea and vomiting in middle ear surgery. Following approval from Institutional Ethics Committee-Human Research (IEC-HR) and prospective CTRI registration, this randomized, double blind interventional study was conducted following informed consent from each participant. Patients aged 16-65 years of either sex, with ASA physical status I or II, undergoing middle ear surgery (tympanoplasty or mastoidectomy) under general anaesthesia were included and divided into group C and L. Group C and L received 50 µg/kg and 25µg/kg ondansetron in combination with 8 mg dexamethasone, respectively.

RESULTS: A total of 120 patients were included . there was a significantly higher number of patients in Group L having PONV score between1-3 than Group C (p value < 0.05). Among group C , six out of 60 patients required metoclopramide in first 2 hours. Significantly higher number of individuals in Group L required anti-emetic than in Group C. (p-value <0.05)

CONCLUSIONS: 50 µg/kg dose combination of ondansetron was more efficacious than 25 µg/kg dose combination with 8 mg dexamethasone for PONV prophylaxis following middle ear surgery.

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