COMPARING THE EFFECT OF ONDANSETRON-DEXAMETHASONE AND METOCLOPRAMIDE-DEXAMETHASONE FOR PREVENTION OF POST OPERATIVE NAUSEA AND VOMITING IN PATIENTS UNDERGOING ELECTIVE LAPAROSCOPIC PROCEDURES

Abstract

Background: Postoperative nausea and vomiting (PONV) remain among the most common and distressing complications following general anesthesia, particularly after laparoscopic procedures. Combination antiemetic therapy is frequently used to improve prophylaxis; however, the comparative efficacy of ondansetron–dexamethasone versus metoclopramide–dexamethasone remains uncertain.

Objectives: To compare the frequency of postoperative nausea and vomiting in patients receiving ondansetron plus dexamethasone versus metoclopramide plus dexamethasone in elective laparoscopic surgery.

Study Design & Setting: A randomized controlled trial conducted at the Department of Anaesthesia, Dow International Medical College, DUHS, OJHA Campus, Karachi.

Methodology: A total of 214 patients undergoing elective laparoscopic procedures were enrolled and equally divided into two groups (n=107 each) using a sealed envelope method. Group A received ondansetron (4 mg) plus dexamethasone (8 mg), while Group B received metoclopramide (10 mg) plus dexamethasone (8 mg) intravenously 15 minutes before the end of surgery. Patients were observed for 24 hours postoperatively for nausea, vomiting, and need for rescue antiemetic. Data were analyzed using SPSS version 25, with p≤0.05 considered significant.

Results: The frequency of nausea was significantly lower in Group A (16.8%) compared to Group B (30.8%) (p=0.01). Similarly, vomiting was observed in 10.3% of patients in Group A and 19.6% in Group B (p=0.04). The requirement of rescue antiemetic was also significantly reduced in Group A (13.1%) compared to Group B (25.2%) (p=0.02). Stratification showed a significant difference in patients with longer duration of surgery (>60 minutes).

Conclusion: Ondansetron combined with dexamethasone was more effective than metoclopramide with dexamethasone in reducing postoperative nausea, vomiting, and the need for rescue antiemetics following elective laparoscopic surgery.