Abstract:
In a prospective randomized double-blind study, we compared the effectiveness of dexamethasone 8 mg with either granisetron 1 mg or ondansetron 4 mg in the prevention of postoperative nausea and vomiting in patients undergoing laparoscopic surgery. Hundred ASA I and II patients scheduled for laparoscopic surgery were enrolled in the study and 84 patients completed it. Following induction of anesthesia, group I (n = 42) received granisetron 1 mg and dexamethasone 8 mg, group II (n = 42) received ondansetron 4 mg and dexamethasone 8 mg. Nausea and vomiting episodes, pain scores as well as side effects were recorded during the first hour and subsequently during the first 6 and 24 hours postoperatively. Satisfaction scores were obtained at discharge. There was no statistically significant difference between the 2 groups during the 1st 24 hours following surgery in regards to pain scores, satisfaction and side effects manifestations. At 0-1 hour interval, 100percent of patients in group I and 97.6percent in group II had no vomiting. Total response (no moderate or severe nausea and no rescue antiemetics) was 83.3percent in group I and 80.95percent in group II, and metoclopramide was used in 7.1percent of patients in both groups. At 1-6 hours interval, 97.6percent of patients in group I and 100percent in group II had no vomiting. Total response was 92.8percent in group I and 90.9percent in group II, and metoclopramide was used in 4.76percent of patients in group I and 2.38percent in group II. At 6-24 hours no vomiting occurred in 97.6percent of patients in group I and 100percent in group II. Total response was 95.2percent in both groups, and metoclopramide was used in 2.38percent of patients in both groups. In conclusion, the combination of dexamethasone 8 mg with either granisetron 1 mg or ondansetron 4 mg following induction of anesthesia in patients undergoing laparoscopic surgery showed no statistically significant difference in antiemetic efficacy with minimal side effects and excellent patient satisfaction.