PONV prophylaxis effect of ondansetron combined with subhypnotic dose propofol or dexamethasone in women undergoing elective laparoscopic surgery
Keywords:
Postoperative nausea and vomitin, laparoscopic surgery, propofol, incidence, general anesthesiaAbstract
Postoperative nausea and vomiting (PONV) is common postoperative complication, result of patient discomfort and other serious complications. Laparoscopy is high risk surgery for PONV. PONV prophylaxis with multiple drug strategy is more effectively than one drug especially in high risk patient. The objective of this study was to assess PONV incidence after prophylaxis with 2 drugs regimen, subhypnotic dose propofol 0.5 mg/kg combined with ondansetron 4 mg (P group) compared with dexamethasone 4 mg combined with ondansetron 4 mg (D group). This study was prospective randomized controlled trial. Inclusion criteria were female adult patients 18-60 years old undergoing elective laparoscopic surgery. Primary end point was PONV incidence in 24 hours postoperatively. Secondary outcomes were rescued antiemetic metoclopramide dose, PONV severity and extubation time. The result showed among 90 patients, found 9 cases of PONV. The incidence of PONV was 10%, P group 5 cases (11.11%) and D group 4 cases (8.89%). There were not statistically significance between the two groups (p-value 0.73). Most patients had PONV during 6-12 hours postoperatively. The most common PONV severity was grade 2. Metoclopramide dose and extubation time were not difference. Mean dose of propofol for PONV prophylaxis in P group was 32.13 ± 5.55 mg. This study concluded that PONV incidence in patients who received 2 drugs for PONV prophylaxis was 10%. Subhypnotic dose propofol plus ondansetron had similar PONV prophylaxis effect as dexamethasone plus ondansetron in female undergoing elective laparoscopic surgery.
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