Comparison of Ondansetron versus Clonidine efficacy for prevention of postoperative pain, nausea and vomiting after orthognathic surgeries: A triple blind randomized controlled trial

Abstract

BackgroundThe aim of this randomized controlled triple blind trial was to compare the efficacy of clonidine with dexamethasone versus ondansetron with dexamethasone for postoperative pain, nausea and vomiting prevention in orthognathic surgery patients.Material and MethodsIn this clinical trial study, 30 consecutive patients with skeletal class III deformities were candidates for orthognathic surgery in Qaem hospital, Mashhad University of medical sciences, Mashhad, Iran from March to November 2017. These subjects were randomly assigned to two equal number groups, ondansetron or clonidine. Patients received either oral ondansetron 8mg or oral clonidine 150μg as premedication, 1 hour before the surgery (both dissolved in 20 cc of water). Also both groups received intravenous dexamethasone 8mg (1 hour preoperatively and every 4 hours intraoperatively).ResultsIn this study, a total of 30 patients (14 males and 16 females) with a mean age of 23.9 ± 3.9 were investigated. The incidence of postoperative nausea in women was more than men (p=0.003), also the correlation between the incidence of PON and the surgery duration ≥ 3 hours was statistically significant (p = 0.050). The frequency of postoperative nausea (PON) in the ondansetron group was less than clonidine (53.3% vs 73.3% respectively). There was no postoperative vomiting (POV) in the ondansetron group, but 6.7% of cases in clonidine group suffered POV. Post-operative nausea in ondansetron group occurred significantly later than clonidine (525.0±233.2 vs 100.0±34.0 min; p<0.001). On the other hand, the incidence time of post-operative severe pain or in other word the analgesia time in clonidine group was significantly more than ondansetron one (875/0±68/5 vs 614.3±159.1 min; p<0.001).ConclusionsOndansetron with dexamethasone premedication was more effective in controlling PONV after orthognathic surgery compared to clonidine with dexamethasone group. Key words:Postoperative nausea and vomiting, ondansetron, clonidine.

Penehyclidine for prevention of postoperative nausea and vomiting following bimaxillary orthognathic surgery: a randomized, double-blind, controlled trial

“…A 5-hydroxytryptamine 3 receptor antagonist plus dexamethasone is a recommended combination for PONV prophylaxis. However, even with combined therapy, the incidence of postoperative nausea was up to 50% in orthognathic patients and higher in bimaxillary cases [ 9 ]. Therefore, combined therapy with a third drug of another category is reasonable for preventing PONV in these patients.…”

Is Preemptive Oral Tizanidine Effective on Postoperative Pain Intensity after Bimaxillary Orthognathic Surgery? A Triple-Blind Randomized Clinical Trial

“…Orthognathic surgery is a widely performed surgical procedure with increasing popularity over the past few decades [1][2][3][4][5] . The state of the art is used to correct severe jaw deformities and maintain a stable dentoskeletal relationship [1][2][3][4][5][6] .…”

“…Orthognathic surgery is a widely performed surgical procedure with increasing popularity over the past few decades [1][2][3][4][5] . The state of the art is used to correct severe jaw deformities and maintain a stable dentoskeletal relationship [1][2][3][4][5][6] . Adequate and efficient acute pain control after surgery is a crucial component for inpatient care and renders uncomplicated recovery and hospital discharge 1,2,7,8 .…”

“…The state of the art is used to correct severe jaw deformities and maintain a stable dentoskeletal relationship [1][2][3][4][5][6] . Adequate and efficient acute pain control after surgery is a crucial component for inpatient care and renders uncomplicated recovery and hospital discharge 1,2,7,8 . Stabilizing intraoperative and postoperative hemodynamic responses, as well as satisfactory pain alleviation is considered an essential measure during the immediate postoperative period after orthognathic surgeries 1,2,4,5 .…”

Effects of Ramosetron on Nausea and Vomiting Following Spinal Surgery: A Meta-Analysis

“…Serotonin (5-hydroxytryptamine 3 [5-HT3]) receptor antagonists, such as ondansetron, granisetron, and dolasetron, are frequently used for PONV prophylaxis. 4 , 5 These antagonists have a considerably short duration of action and are thus commonly used in the immediate postoperative period, but they are less effective at preventing postoperative vomiting (POV) than postoperative nausea (PON). 6 Several meta-analyses have reported that an intravenous dose of the serotonin antagonist ramosetron (0.3 mg) has better efficacy and longer duration of action than other serotonin receptor antagonists after nonorthopedic surgery.…”