Comparison of Efficacy of Clonidine versus Ondansetron for Prevention of Nausea and Vomiting Post Thyroidectomy: A Double Blind Randomized Controlled Trial
Background and Aim: Postoperative nausea vomiting (PONV) is the most common symptom in patients post thyroidectomy. Literature search shows conflicting results regarding use of clonidine in PONV prophylaxis. We undertook this randomized controlled double blind trial to compare the efficacy of cl...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2015-05-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/5866/12721_CE(RA1)_F(T)_PF1(PAK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Background and Aim: Postoperative nausea vomiting (PONV) is the
most common symptom in patients post thyroidectomy. Literature
search shows conflicting results regarding use of clonidine in PONV
prophylaxis. We undertook this randomized controlled double
blind trial to compare the efficacy of clonidine with dexamethasone
versus ondansetron with dexamethasone for PONV prophylaxis in
these patients.
Materials and Methods: In this prospective study, 60 consecutive
patients posted for thyroidectomy from August 2013 to July 2014,
were randomly assigned to two groups, ondansetron (N= 30)
(Group A) and clonidine (N= 30) (Group B). Patients received either
oral ondansetron 8mg or oral clonidine 150µg as premedication.
At the end of surgery, both groups received dexamethasone 8mg
intravenously. They were monitored for occurrence of PONV and
sore throat for next 24 h. Ramsay sedation scores and total time of
analgesia was noted. The primary end point was incidence of PONV
in post operative for 24 h. Pearson’s chi square test and Students
t tests were performed using SPSS for windows version 20 (SPSS
Inc., Chicago, IL).
Results: Baseline characteristics of patients were comparable. A
higher proportion of patients in clonidine group developed PONV
than ondansetron (36.7% vs 30%; p=0.03). Clonidine group patients
experienced early nausea and vomiting (1-2hrs of postoperative
period), compared to ondansetron group patients (6-12 h). Ramsay
sedation scores at arrival were higher in clonidine group compared
to ondansetron group (2.1 ± 0.3 versus 2.0; p=0.003). Total time of
analgesia was higher with use of clonidine than ondansetron (919.5
± 622 mins versus 642 ± 631 mins; p=0.09). Moderate sore throat
was seen in 2 out of 30 patients in both groups. No major adverse
events were observed in either group.
Conclusion: Ondansetron with dexamethasone group was more
effective in controlling PONV after thyroidectomy compared to
clonidine with dexamethasone group. However, ramsay sedation
scores and total time of analgesia were higher with clonidine than
ondansetron. |
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| ISSN: | 2249-782X 0973-709X |