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...
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JCDR Research and Publications Private Limited
2023-11-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| 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 |
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| author | Usha R Sastry M Manjula Devi Gifty Susan Philip CB Pratibha Jeson Yata Niny Sara George |
| author_facet | Usha R Sastry M Manjula Devi Gifty Susan Philip CB Pratibha Jeson Yata Niny Sara George |
| author_sort | Usha R Sastry |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-09T09:00:52Z |
| format | Article |
| id | doaj.art-1364ab7e5ec4458599007047b8581fe1 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-03-09T09:00:52Z |
| publishDate | 2023-11-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-1364ab7e5ec4458599007047b8581fe12023-12-02T11:30:28ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2023-11-0117113843 10.7860/JCDR/2023/64039.18756Efficacy of Gabapentin versus Combination of Dexamethasone-Ondansetron in Prevention of Postoperative Nausea and Vomiting in Middle Ear Surgery: A Randomised Clinical StudyUsha R Sastry0M Manjula Devi1Gifty Susan Philip2CB Pratibha3Jeson Yata4Niny Sara George5Assistant Professor, Department of Anaesthesiology and Critical Care, St John’s Medical College and Hospital, Bengaluru, Karnataka, India.Professor, Department of Anaesthesiology and Critical Care, St John’s Medical College and Hospital, Bengaluru, Karnataka, India.Assistant Professor, Department of Anaesthesiology and Critical Care, St John’s Medical College and Hospital, Bengaluru, Karnataka, India.Associate Professor, Department of Otorhinolaryngology, St John’s Medical College and Hospital, Bengaluru, Karnataka, India.Junior Resident, Department of Anaesthesiology and Critical Care, BGS Global Hospital, Bengaluru, Karnataka, India.Junior Resident, Department of Anaesthesiology and Critical Care, Sagar Hospitals, Bengaluru, Karnataka, India.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.https://www.jcdr.net/articles/PDF/18756/64039_CE[Ra1]_QC(PC)_F(SS)_PF1(AG_OM)_PFA(KM)_PB(AG_OM)_PN(OM).pdfanalgesiaantiemeticstherapy |
| spellingShingle | Usha R Sastry M Manjula Devi Gifty Susan Philip CB Pratibha Jeson Yata Niny Sara George Efficacy of Gabapentin versus Combination of Dexamethasone-Ondansetron in Prevention of Postoperative Nausea and Vomiting in Middle Ear Surgery: A Randomised Clinical Study Journal of Clinical and Diagnostic Research analgesia antiemetics therapy |
| title | Efficacy of Gabapentin versus Combination of Dexamethasone-Ondansetron in Prevention of Postoperative Nausea and Vomiting in Middle Ear Surgery: A Randomised Clinical Study |
| title_full | Efficacy of Gabapentin versus Combination of Dexamethasone-Ondansetron in Prevention of Postoperative Nausea and Vomiting in Middle Ear Surgery: A Randomised Clinical Study |
| title_fullStr | Efficacy of Gabapentin versus Combination of Dexamethasone-Ondansetron in Prevention of Postoperative Nausea and Vomiting in Middle Ear Surgery: A Randomised Clinical Study |
| title_full_unstemmed | Efficacy of Gabapentin versus Combination of Dexamethasone-Ondansetron in Prevention of Postoperative Nausea and Vomiting in Middle Ear Surgery: A Randomised Clinical Study |
| title_short | Efficacy of Gabapentin versus Combination of Dexamethasone-Ondansetron in Prevention of Postoperative Nausea and Vomiting in Middle Ear Surgery: A Randomised Clinical Study |
| title_sort | efficacy of gabapentin versus combination of dexamethasone ondansetron in prevention of postoperative nausea and vomiting in middle ear surgery a randomised clinical study |
| topic | analgesia antiemetics therapy |
| url | 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 |
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