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Hypovolemia is a state of decreased blood volume. Both crystalloids and colloids can be used but may influence coagulation beyond hemodilution. Hydroxy ethyl starch (HES) is colloids that are routinely used as intravascular volume substitutes. This prospective Randomized double blinded study was conducted in 60 patients to demonstrate the equivalence of two different molecular weight of HES in the initial management of Hypovolemia. Tetra starch (Voluven) HES130/0.4 produced excellent effect and makes it an advantage especially in hypovolemic patients because of Adequate Volume Effect Reduced tissue elimination, improved safety profile, Increased Renal elimination.

Postoperative nausea and vomiting (PONV) along with pain and shivering are frequently observed in patients recovering from surgery and general anesthesia. To compare the efficacy of Ramosetron alone and in Combination with Dexamethasone in patients undergoing laparoscopic surgeries, with respect to nausea, vomiting , requirement of rescue analgesia and antiemetics, discharge time, and also side effects.Current study was a prospective observational double-blind study conducted at a tertiary care hospital. A total of 60 ASA grade I and II patients of age group 20-50 years undergoing elective laparoscopic surgeries under general anesthesia with Body mass index between 18-25 were included in the study. Participants were divided by using a computer-generated random number table into two groups of 30 each with Group R and Group RD each consisting of 30 patients. Group R received 0.3 mg. of Ramosetron intravenous (IV) and group RD received both 0.3mg. P value < 0.05 was considered statistically significant. coGuide version V.1.0.3 was used for statistical analysis.The mean duration of surgery in group R was 35.83 ± 6.44 minutes and 35.66 ± 6.26 minutes in group RD. The difference in the proportion of PONV scores between the study group was statistically not significant (P value 0.982). The rescue antiemetic was used in 5 (16.67%) patients in group R and in 2(6.67%) patients in group RD. Combination therapy of Ramosetron with dexamethasone had better efficacy than Ramosetron alone in reducing PONV on patients undergoing laparoscopic surgeries.

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