Comparison of Prophylactic Anti-Emetic Effects of Ondansetron and Dexamethasone in Women Undergoing Day-Case Gynaecological Laparoscopic Surgery

Abstract

We aimed to determine the effect of ondansetron and dexamethasone on preventing post-operative nausea and vomiting (PONV). Sixty women undergoing laparoscopic gynaecological surgery were randomized to receive ondansetron 4 mg, dexamethasone 8 mg or saline. Drugs were administered 2 min before induction of anaesthesia, and anaesthesia and post-operative analgesic regimens were standardized. The incidence of PONV in the first 24 h after the operation was 35% in the ondansetron group, 55% in dexamethasone group and 85% in the control group. A significant difference between the groups was only seen in the first 3 h post-operatively. In this period, ondansetron was significantly more effective than dexamethasone and saline, but no differences were seen between dexamethasone and saline. In all treatment groups, post-operative visual analogue scale scores, sedation scores and usage of analgesics were similar. In conclusion, ondansetron, but not dexamethasone, prevented PONV in the first 3 h after gynaecological laparoscopic surgery.

Endocrine and Immune Effects of Dexamethasone in Unilateral Total Knee Replacement

“…10 A single 8 mg dose of dexamethasone was unsuccessful as an antiemetic. 11 In contrast, in a larger study of 300 patients, 4 mg dexamethasone administered after the induction of anaesthesia, with a second dose on the morning after surgery, significantly reduced nausea and vomiting and improved appetite. 12 This suggests another possible beneficial effect of dexamethasone treatment in the prevention of catabolic processes.…”

Practice Guidelines for Postanesthetic Care

“…Meta-analyses of new double-blind RCTs comparing dexamethasone with placebo controls corroborate findings reported in the original Guidelines indicating that this antiemetic is effective in the prophylaxis of postoperative vomiting and reduced use of rescue antiemetics, and for the prophylaxis of nausea when higher doses are administered (Category A1-B evidence). 8,12,24,26,29,36,37,39,41,43,44,[47][48][49][50][51][52][53][54][55][56] The consultants and ASA members agree that the pharmacologic prophylaxis of nausea and vomiting improves patient comfort and satisfaction, reduces time to discharge, and should be done selectively. Multiple Pharmacologic Agents for Prophylaxis of Nausea and Vomiting.…”

“…Drugs evaluated by these Guidelines for the prophylaxis of nausea and vomiting include: (1) antihistamines, (2) 5-HT3 antiemetics, (3) tranquilizers/neuroleptics, (4) metoclopramide, (5) scopolamine, and (6) 2-6 granisetron (reduced vomiting), [7][8][9][10][11] ondansetron (reduced vomiting and rescue antiemetics), [7][8][9][12][13][14][15][16][17][18][19][20][21][22][23][24] and tropisetron (reduced vomiting and rescue antiemetics).…”

Manual de práctica clínica basado en la evidencia: Controles posquirúrgicos

“…Los medicamentos específicos son: dolasetrón (reduce el vómito) [23][24][25][26][27] , granisetrón (reduce el vómito) 28-32 y ondansetrón (reduce el vómito y rescates antieméticos) [28][29][30][33][34][35][36][37][38][39][40][41][42][43][44][45] .…”

“…El metaanálisis de ECC reporta que este antiemético es efectivo en la profilaxis del vómito postoperatorio (reduce el uso de antieméticos de rescate) y como profilaxis de náusea (se observó efectividad a mayores dosis) (evidencia categoría A1-B) 29,33,45,48,49,51,52,[54][55][56][57][58][59][60][61][62][63][64][65][66][67] .…”