Post operative nausea and vomiting (PONV) continue to be frequent occurrences, even when conventional antiemetics are prophylactically used. In a randomized double blind study, 60 female patients scheduled for elective laparoscopic cholecystectomy under general anaesthesia were divided into 2 groups of 30 patients each and received 4 mgs of Ondansetron (Group I) or a combination of Ondansetron 4 mgs and 4 mgs of dexamethasone (Group II) pre-operatively. Patients were observed for 24 hours post operatively and interpretation of symptoms of nausea and vomiting was done according to Gan and Alexander scale (0-2). 70 % of patients in Group II and 43 % patients in Group I did not experience PONV; the difference was statistically significant (p<0.01). 3 patients (10%) in Group II and 10 patients (33%) in Group I required rescue antiemetic medication during the 24 hour study period. The difference was found to be highly significant(p<0.001) The difference in the incidence of PONV between the two groups after 6 hours to 24 hours was highly significant (p<0.001). It was concluded that prophylactic administration of combination of Ondansetron and dexamethasone is effective than Ondansetron when used alone, in reducing in incidence of PONV with prolonged effects.
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