Efficacy of Gabapentin versus Combination of Dexamethasone-Ondansetron in Prevention of Postoperative Nausea and Vomiting in Middle Ear Surgery: A Randomised Clinical Study
Introduction: Postoperative Nausea and Vomiting (PONV) is the most common and unpleasant complication with incidence of 30-80% after elective surgery. Dexamethasone and Ondansetron (DO) combination has superior efficacy and is recommended as an ideal choice for prevention of PONV in Middle Ear S...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2023-11-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/18756/64039_CE[Ra1]_QC(PC)_F(SS)_PF1(AG_OM)_PFA(KM)_PB(AG_OM)_PN(OM).pdf |
| Summary: | Introduction: Postoperative Nausea and Vomiting (PONV) is the
most common and unpleasant complication with incidence of
30-80% after elective surgery. Dexamethasone and Ondansetron
(DO) combination has superior efficacy and is recommended as
an ideal choice for prevention of PONV in Middle Ear Surgery
(MES). Oral Gabapentin, an anticonvulsant has been introduced
as an antiemetic to fast-track bundles and enhanced recovery
after surgery.
Aim: To compare the efficacy of DO with gabapentin monotherapy
in prevention of PONV in patients undergoing MES.
Materials and Methods: This randomised, double-blind, parallel
group clinical study was done at Department of Anaesthesiology,
St John’s Medical College, Bengaluru, Karnataka, India from
November 2018 to March 2020. Sixty-six of patients were
randomised to Group DO (Intravenous Dexamethasone at
start and Ondansetron at end of surgery, 100 μg/kg each) and
Group G (Oral Gabapentin 300 mg one hour prior to surgery).
Postoperatively, incidence and severity of PONV, duration
of antiemesis and analgesia, total rescue antiemetics and
analgesics, along with side-effects were assessed for 24 hour
period. Descriptive statistics was summarised for continuous
(mean and standard deviation) and categorical (number with
percentages) variables. Inferential statistics were depicted
using Fisher’s-exact and Student’s t-test.
Results: The demographic profile was comparable between the
two groups. Incidence of PONV was significantly lesser in Group
DO compared to the Group G (12% versus 36%, p-value=0.0129).
Duration of antiemesis was four hours in Group DO and two
hours in Group G was statistically significant (p-value=0.021).
Severity of PONV was significant (p-value=0.033 and 0.009,
respectively) at four and six hours between the groups. Duration
of analgesia (6.28±5.96 in Group DO versus 5.62±3.63 hours in
Group G; p-value=0.252), rescue analgesics and side-effects
were comparable between the two groups (p-value>0.05).
Conclusion: In MES, DO combination reduced the incidence
and severity of PONV and is better prophylactic antiemetic
therapy than gabapentin alone. |
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| ISSN: | 2249-782X 0973-709X |