Comparison of Dexamethasone with Ondansetron or Haloperidol for Prevention of Patient‐Controlled Analgesia‐Related Postoperative Nausea and Vomiting: A Randomized Clinical Trial

Wang, Po-Kai; Tsay, Pei-Jiuan; Huang, Chia-Chun; Lai, Hsien-Yong; Lin, Pei‐Chin; Huang, Sheng-Yao; Lee, Yi

doi:10.1007/s00268-012-1446-y

Cited by 21 publications

(17 citation statements)

References 39 publications

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“…These findings coincide with those of Lopez et al 1996 11 and Wang et al 2012 22 found no significant differences in pain intensity between all the three groups at any time interval. In our study we compared the incidence of sedation in all the three groups at 2 hours, 12 hours and 24 hours using the five point sedation scale (Graph 2).…”

Section: Discussionsupporting

confidence: 82%

Comparison of Ondansetron with Ondansetron and Dexamethasone in prevention of postoperative nausea vomiting in abdominal surgery

Ajani¹,

Singam²,

Chaudhari³

et al. 2013

Int J of Biomed & Adv Res

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Purpose: To compare the efficacy of ondansetron-dexamethasone combination with ondansetron alone for prevention of postoperative nausea and vomiting (PONV).

Methods: This double blind, randomized, prospective, Placebo controlled study was carried out in 120 patients, aged 20-60 yr, ASA-I and II physical status posted for exploratory laparotomy for various clinical conditions under general anaesthesia The patients were divided into three groups of 40 each.

Patients received one of the three regimes for prevention of PONV before induction.

Group P : Received 4 ml Normal saline I.V,

Group O : Received injection Ondansetron 4mg (2 ml) + 2 ml Normal Saline.

Group OD : Received injection Ondansetron 4 mg (2 ml) and injection Dexamethasone 8mg( 2 ml).

Nausea and vomiting were looked from 0 min upto 24 hours. Retching and vomiting were grouped together under common term ' emetic episodes '.

Results: Though ondansetron was effective in controlling postoperative nausea, the ondansetron plus dexamethasone combination was more effective overall. Though ondansetron was effective in reducing postoperative emetic episodes, the combination of ondansetron plus dexamethasone was more effective.The requirement for rescue antiemetic was less in ondansetron group and least in ondansetron plus dexamethasone group. There was no significant difference between pain intensity and sedation between these groups at any time. Only adverse effect reported was headache in ondansetron and ondansetron plus dexamethasone groups.

Conclusion: Ondansetron plus dexamethasone combination is more effective in reducing incidence of PONV without causing any major side effects. Throughout the study, ondansetron plus dexamethasone combination was superior to ondansetron alone in all respects pointing towards the potentiating effect of dexamethasone.

Keywords : PONV, Ondansetron, Dexamethasone, General Anesthesia.

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Section: Discussionsupporting

confidence: 82%

Comparison of Ondansetron with Ondansetron and Dexamethasone in prevention of postoperative nausea vomiting in abdominal surgery

Ajani¹,

Singam²,

Chaudhari³

et al. 2013

Int J of Biomed & Adv Res

View full text Add to dashboard Cite

Purpose: To compare the efficacy of ondansetron-dexamethasone combination with ondansetron alone for prevention of postoperative nausea and vomiting (PONV).

Patients received one of the three regimes for prevention of PONV before induction.

Group P : Received 4 ml Normal saline I.V,

Group O : Received injection Ondansetron 4mg (2 ml) + 2 ml Normal Saline.

Group OD : Received injection Ondansetron 4 mg (2 ml) and injection Dexamethasone 8mg( 2 ml).

Nausea and vomiting were looked from 0 min upto 24 hours. Retching and vomiting were grouped together under common term ' emetic episodes '.

Keywords : PONV, Ondansetron, Dexamethasone, General Anesthesia.

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“…2a. Twenty-one studies were excluded from the analysis because they reported zero events in all arms [39, 43, 57, 60, 61, 71, 73, 81, 82, 86, 90, 92–94, 98, 110, 121, 127, 145, 155, 156]. Although the definitions of arrhythmia varied across the studies (Additional file 1: Appendix 10), there was no evidence of network inconsistency ( χ 2 = 3.49, degrees of freedom = 10, P = 0.968, heterogeneity variance = 0.01), and the within-network heterogeneity variance was estimated to be 0.00.…”

Section: Resultsmentioning

confidence: 99%

Comparative safety of serotonin (5-HT3) receptor antagonists in patients undergoing surgery: a systematic review and network meta-analysis

Tricco

Soobiah

Blondal

et al. 2015

BMC Med

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BackgroundSerotonin (5-HT3) receptor antagonists are commonly used to decrease nausea and vomiting for surgery patients, but these agents may be harmful. We conducted a systematic review on the comparative safety of 5-HT3 receptor antagonists.MethodsSearches were done in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify studies comparing 5-HT3 receptor antagonists with each other, placebo, and/or other antiemetic agents for patients undergoing surgical procedures. Screening search results, data abstraction, and risk of bias assessment were conducted by two reviewers independently. Random-effects pairwise meta-analysis and network meta-analysis (NMA) were conducted. PROSPERO registry number: CRD42013003564.ResultsOverall, 120 studies and 27,787 patients were included after screening of 7,608 citations and 1,014 full-text articles. Significantly more patients receiving granisetron plus dexamethasone experienced an arrhythmia relative to placebo (odds ratio (OR) 2.96, 95 % confidence interval (CI) 1.11–7.94), ondansetron (OR 3.23, 95 % CI 1.17–8.95), dolasetron (OR 4.37, 95 % CI 1.51–12.62), tropisetron (OR 3.27, 95 % CI 1.02–10.43), and ondansetron plus dexamethasone (OR 5.75, 95 % CI 1.71–19.34) in a NMA including 31 randomized clinical trials (RCTs) and 6,623 patients of all ages. No statistically significant differences in delirium frequency were observed across all treatment comparisons in a NMA including 18 RCTs and 3,652 patients.ConclusionGranisetron plus dexamethasone increases the risk of arrhythmia.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-015-0379-3) contains supplementary material, which is available to authorized users.

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“…One of the commonly used combinations for preventing PONV is a 5-HT 3 receptor antagonist with dexamethasone. It has been demonstrated that combining a 5-HT 3 receptor antagonist (ondansetron or ramosetron) with dexamethasone is more effective in preventing PONV than ondansetron, ramosetron or dexamethasone alone [ 7 , 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

The effect of combination treatment using palonosetron and dexamethasone for the prevention of postoperative nausea and vomiting versus dexamethasone alone in women receiving intravenous patient-controlled analgesia

Ryoo¹,

Yoo

Kim

et al. 2015

Korean J Anesthesiol

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BackgroundThe purpose of this study was to evaluate the effect of palonosetron combined with dexamethasone for the prevention of PONV compared to dexamethasone alone in women who received intravenous patient-controlled analgesia (IV-PCA) using fentanyl.MethodsIn this randomized, double-blinded, placebo-controlled study, 204 healthy female patients who were scheduled to undergo elective surgery under general anesthesia followed by IV-PCA for postoperative pain control were enrolled. Patients were divided into two groups: the PD group (palonosetron 0.075 mg and dexamethasone 5 mg IV; n = 102) and the D group (dexamethasone 5 mg IV; n = 102). The treatments were given after the induction of anesthesia. The incidence of nausea, vomiting, severity of nausea, and the use of rescue anti-emetics during the first 48 hours after surgery were evaluated.ResultsThe incidence of PONV was significantly lower in the PD group compared with the D group during the 0-24 hours (43 vs. 59%) and 0-48 hours after surgery (45 vs. 63%) (P < 0.05). The severity of nausea during the 6-24 hours after surgery was significantly less in the PD group compared with the D group (P < 0.05). The incidence of rescue antiemetic used was significantly lower in the PD group than in the D group during the 0-6 hours after surgery (13.1 vs. 24.5%) (P < 0.05).ConclusionsPalonosetron combined with dexamethasone was more effective in preventing PONV compared to dexamethasone alone in women receiving IV-PCA using fentanyl.

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Comparison of Dexamethasone with Ondansetron or Haloperidol for Prevention of Patient‐Controlled Analgesia‐Related Postoperative Nausea and Vomiting: A Randomized Clinical Trial

Cited by 21 publications

References 39 publications

Comparison of Ondansetron with Ondansetron and Dexamethasone in prevention of postoperative nausea vomiting in abdominal surgery

Comparison of Ondansetron with Ondansetron and Dexamethasone in prevention of postoperative nausea vomiting in abdominal surgery

Comparative safety of serotonin (5-HT3) receptor antagonists in patients undergoing surgery: a systematic review and network meta-analysis

The effect of combination treatment using palonosetron and dexamethasone for the prevention of postoperative nausea and vomiting versus dexamethasone alone in women receiving intravenous patient-controlled analgesia

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