No abstract

PONV occurs frequently after day case gynaecological surgery both 5-HT3 antagonists and dexamethasone are superior to placebo in the prophylaxis of PONV in his setting.Our study has compared. The efficacy of ondansetron plus dexamethasone with each anti-emetic alone for the prevention of PONV in patients undergoing day case gynaecological surgery. Present study was undertaken on 120 patients in the age group of to 65 years with ASA grades I & II undergoing gynaecologic laparoscopic intervention under general anaesthesia. Group 1 received Inj. Ondansetron 4mg with Inj. Dexamethasone 8mg as single dose I V bolus 5 minutes before induction of anaesthesia.Group 2 received Inj. Ondansetron 4mg as single dose I V bolus 5 minutes before induction of anaesthesia.Group 3 received Inj. Dexamethasone 8mg as single dose I V bolus 5 minutes before induction of anaesthesia.A standard anaesthetic protocol was used in all the patients. 5 min prior, the patients received the anti-emetic as per their groups Induction of general anaesthesia was done with Inj. Propofol 2-3 mg / kg IV. Intubating conditions were achieved with Inj. Suxamethonium 2 mg / kg I V. Trachea was intubated with appropriate sized cuffed PVC endotracheal tube. General anaesthesia was maintained with O2 + N2O::40:60.,skeletal l muscle relaxation was maintained with of Inj. Atracurium 0.5mg / kg as loading dose and 0.05mg/kg as supplemental doses. The duration of anaesthesia, surgery, pneumoperitoneum was noted.Nasogastric tube was introduced after induction & suction of gastric contents was done before recovery & was removed after extubation.The patients were evaluated at regular intervals of time in the post operative period for complaints of nausea, vomiting.As per our observations, the incidence of PONV in 0-4 hours post operative period was statistically significant. The observations were inconclusive beyond the 4 hour period in combination group as well as either drug group. Combination of Inj. Ondansetron 4mg with Inj. Dexamethasone 8mg proved to be more efficacious over either drug alone.

As part of a prospective study of neuropsychologic reactions after cardiopulmonary bypass and their relation to arterial line filters, 44 patients who underwent elective cardiac operations were randomized into two groups. Group A had a 40-micron nylon screen filter in the arterial line. No arterial filter was used in group B. Neuropsychological examinations of all patients were conducted before and at a mean of 8 days after the operation on a double blind basis by a single trained psychologist. The tests included the Wechsler Memory Scale, the trail-making test, the Hamilton Anxiety Rating Scale, and the Hamilton Rating Scale for Depression. The 2 groups were otherwise similar with respect to preoperative neurologic and intellectual status, anesthetic methods, duration of operation, operative procedures performed, and the time spent in the intensive care unit. Surprisingly, there was a highly significant improvement in all four test scores after surgery. There were no statistically significant differences in the test scores between the two groups but considerable inter-patient performance variability was noted. The arterial line filter did not appear to have an effect on test scores. Routine use of an arterial filter remains questionable.