Comparative Effectiveness of Ondansetron, Dexamethasone, and Their Combination in Preventing Postoperative Nausea and Vomiting in Ear Nose and Throat Surgeries under general anaesthesia
Authors: Dr Allen Joe Rodrigues, Dr Abhishek C P, Dr Eshanu H Shastry, Dr Abhishek Acharya, Dr Susheela s Halemani
Keywords: Postoperative Nausea and Vomiting, Ondansetron, Dexamethasone, Otolaryngologic Surgical Procedures, General Anesthesia, Antiemetics
Abstract:
Abstract
Background:
Postoperative nausea and vomiting (PONV) is a frequent complication following general anaesthesia, particularly in patients undergoing Ear, Nose, and Throat (ENT) surgeries. Vestibular stimulation and middle ear manipulation increase the risk of PONV. Ondansetron and dexamethasone are commonly used antiemetic agents, and combination therapy may improve prophylaxis.
Objectives:
To compare the efficacy of ondansetron, dexamethasone, and their combination in preventing postoperative nausea and vomiting in patients undergoing elective ENT surgeries under general anaesthesia.
Methods:
This prospective, randomized, double-blinded study included 104 adult patients with American Society of Anaesthesiologists physical status I–II scheduled for elective ENT surgeries. Patients were randomly allocated to receive intravenous ondansetron 4 mg, dexamethasone 8 mg, or a combination of ondansetron 4 mg and dexamethasone 8 mg before induction of anaesthesia. The incidence of nausea and vomiting was assessed during the early (0–1 hour) and late (1–6 hours) postoperative periods, and the requirement for rescue antiemetic therapy was recorded.
Results:
The combination group demonstrated a significantly lower overall incidence of postoperative nausea and vomiting compared to the ondansetron and dexamethasone groups. Late postoperative vomiting was not observed in patients receiving combination prophylaxis. No rescue antiemetic medication was required in the combination group. Ondansetron alone showed reduced efficacy against late postoperative nausea and vomiting, while dexamethasone alone was less effective during the early postoperative period.
Conclusion:
Combination prophylaxis with ondansetron and dexamethasone provides superior control of postoperative nausea and vomiting compared with either agent alone in patients undergoing ENT surgeries under general anaesthesia safely.
