18. THE EFFECTIVENESS OF DEXAMETHASONE AND ONDANSETRON IN PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING IN PATIENT UNDERGOING LAPAROSCOPIC CHOLESCYSTECTOMY AT GENERAL HOSPITAL OF CENTRAL HIGHLANDS
Main Article Content
Abstract
Background: Endoscopic cholecystectomy is a routine surgical treatment of gallbladder stones. Endoscopy is less invasive than open surgery, but the incidence of postoperative nausea and vomiting is higher than open surgery, about 40-70%. The prophylactic efficacy of Ondansetron for postoperative nausea and vomiting has been demonstrated through numerous studies. Dexamethasone is an easy-to-find and cheap drug, but has not been widely used in the prevention of nausea and vomiting after surgery.
Research objects and methods: Randomized clinical intervention study with control group, single blind. Comparison of nausea - vomiting prophylaxis efficacy of Dexamethasone and Ondansetron in the first 24 hours after laparoscopic cholecystectomy in 208 patients. Group D (Dexamethasone) 105 patients received 4 mg of Dexamethasone intravenously upon induction, Group O (Ondansetron) 103 patients received 8 mg of Ondansetron intravenously upon induction. All patients received postoperative care and treatment according to the same protocol. Patients were assessed for postoperative nausea - vomiting during the first vomiting period. Monitor for vomit prevention medicine side effects such as headache, dizziness...
Results: Nausea - vomiting prophylaxis effect of Dexamethasone and Ondansetron in the first 24 hours after laparoscopic cholecystectomy, postoperative nausea-vomiting rates of patients undergoing laparoscopic cholecystectomy with one or more risk factors according to Apfel, in the group prophylactic with Dexamethasone 4 mg, 16.5% compared to the group prophylactic with Ondansetron 8 mg, 20%, were similar.
Conclusions: The nausea - emesis prevention effect of Dexamethasone 4 mg and Ondansetron 8 mg in the first 24 hours after laparoscopic cholecystectomy is almost the same.
Article Details
Keywords
Postoperative nausea and vomiting, Dexamethasone, Ondansetron
References
[2] Arslan M, Cicek R, Yilmaz H, Preventing postoperative nausea and vomiting after laparoscopic cholecystectomy: a prospective, randomized, double-blind study, Curr Ther Res Clin Exp, 2011, 72 (1), 1-12.
[3] Fujii Y, Management of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy, Surg Endosc, 2011, 25 (3), 691-5.
[4] Gautam B et al, Antiemetic prophylaxis against postoperative nausea and vomiting with Ondansetron - Dexamethasone combination compared to Ondansetron or Dexamethasone alone for patients undergoing laparoscopic cholecystectomy, Kathmandu University Medical Journal, 2009, 6(3), pp. 319-328.
[5] Grimsehl K, Whiteside JB, Mackenzie N, Comparison of cyclizine and Ondansetron for the prevention of postoperative nausea and vomiting in laparoscopic day-case gynaecological surgery, Anaesthesia, 2002, 57 (1), 61-5.
[6] Gautam B, Shrestha BR, Lama P, Rai S, Antiemetic prophylaxis against postoperative nausea and vomiting with Ondansetron - Dexamethasone combination compared to Ondansetron or Dexamethasone alone for patients undergoing laparoscopic cholecystectomy, Kathmandu Univ Med J (KUMJ), 2008, 6 (23), 319-28.
[7] Iitomi T, Toriumi S, Kondo A, Akazawa T, Nakahara T, Incidence of nausea and vomiting after cholecystectomy performed via laparotomy or laparoscopy, Masui, 1995, 44 (12), 1627-31.
[8] Kim EJ et al, Combination of antiemetics for the prevention of postoperative nausea and vomiting in high-risk patients, J Korean Med Sci., 2007, 22(5), pp. 878-82.
[9] Lê Hồng Chính, Nghiên cứu so sánh hiệu quả dự phòng buồn nôn, nôn sau mổ của Ondansetron và Dexamethasone trong mổ nội soi cắt túi mật, Luận văn thạc sỹ, chuyên ngành gây mê hồi sức, Trường Đại học Y Dược thành phố Hồ Chí Minh, 2014.