A study to compare dexamethasone and ondansetron for preventing postopera-tive nausea and vomiting in children undergoing tonsillectomy

Abstract

SUMMARYObjective: Various drugs have been used as antiemetics for treatment of postoperative nausea and vomiting. The present study was undertaken to assess the efficacy of ondansetron and dexamethasone for preventing postoperative nausea and vomiting in children undergoing tonsillectomies. Method: Sixty children having ASA physical status Grade I or II in the age group 4-12 years undergoing tonsillectomy under general anaesthesia were included in the study. These were allocated to three groups of twenty patient each. After induction patients were given test solution A (2 mL) comprising of normal saline or dexamethasone 500 µg/kg or 150 µg/kg in Group I, II and III respectively. At the end of surgery before switching off anaesthetics, test solution B (2 mL) was given comprising of ondansetron 0.15 mg/kg (maximum upto 4 mg) or normal saline or ondansetron 0.1 mg/kg (maximum upto 2 mg). Postoperatively incidence of nausea, number of vomiting episodes, frequency of administration of rescue antiemetic and analgesic were recorded. Results: In Group II 80% of patients had nausea as compared to 70% in Group I and 50% in group III and the difference between Group II and III was statistically significant (p<0.05). 30% of the patients had vomiting in Group I and II and only 15% of the patients in Group III. The frequency of rescue analgesic among the three groups was comparable except at 0.5 hours. 50% of patients showed complete response in Group III, as compared to 30% and 20% in Group I and Group II respectively. Conclusion:The combined regimen of ondansetron with dexamethasone was more efficacious as an antiemetic in controlling postoperative nausea and vomiting in children undergoing tonsillectomy. Keywords: Postoperative nausea and vomiting, dexamethasone, ondansetron, tonsillectomy ÖZET Amaç: Postoperatif bulantı ve kusmanın tedavisi için antiemetic olarak çeşitli ilaçlar kullanılmaktadır. Bu çalışmada tonsillektomi yapılan çocuklarda postoperative bulantı ve kusmayı önlemek için ondansetron ve deksametazonun etkinliği değerlendirilmektedir. Yöntem: Genel anestezi altında tonsillektomi yapılan 4-12 yaşları arasında Grade I ve Grade II ASA fiziksel durumuna sahip 60 çocuk çalışmaya dahil edildi. Bunlar her biri 20'şer kişiden oluşan üç gruba ayrıldı. İndüksiyondan sonra sırasıyla Grup I, Grup II ve Grup III'deki hastalara normal salin ya da deksametazon 500 µg/kg ya da 150 µg/kg'dan oluşan test solüsyonu A (2 mL) verildi. Cerrahinin sonunda, anestezikleri "switch" yapmadan önce test solüsyonu B (2 mL) At the end of surgery before switching off anaesthetics, ondansetron 0.15 mg/kg (maksimum 4 mg) ya da 214 CMJCumhuriyet Medical Journal normal salin ya da ondansetron 0.1 mg/kg (maksimum 2 mg)'dan oluşan test solüsyonu B (2 mL) verildi. Postoperatif bulantı ve kusma sayısı, antiemetic ve analjezik uygulama sıklığı kaydedildi. Bulgular: Grup II'de hastaların %80'inde, Grup I'deki %70 ve Grup III'deki %50 ile karşılaştırıldığında bulantıya sahipti. Grup II ve III arasındaki fark istatistiksel olarak anlamlı idi (p<0.05)....