COMPARING THE EFFECTIVENESS OF DEXAMETHASONE, ONDANSETRON AND METOCLOPRAMIDE IN CONTROLLING POST OPERATIVE NAUSEA AND VOMITING IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

Background: The most frequent complication of laparoscopic cholecystectomy is postoperative nausea and vomiting (PONV) that occurs in 30-50% of patients and in up to 70-80% of high risk patients, causing post-operative discomfort, delayed recovery, and higher health care expense. Dexamethasone, ondansetron and metoclopramide are prevalent against PONV prophylaxis even though there are few studies comparing the effectiveness of single drug use which have been done in the Pakistani context.

Objectives: The purpose of this study is to compare the effects of the use of dexamethasone, ondansetron and metoclopramide, separately, in preventing PONV among the patients undergoing laparoscopic cholecystectomy under general anaesthesia. It is also aimed at comparing the occurrence and level of the post operative nausea experienced within 24 hours among the three groups.

Methods: A prospective, randomized, controlled trial was recruit 150 ASA I-II adult patients (18-65 years of age) presented with elective laparoscopic cholecystectomy at Lady Reading Hospital, Peshawar. The patients was be assigned to three groups (50 each) where they was be given dexamethasone, ondansetron or metoclopramide after induction. The results was focus on the number and extent of PONV (measured through Visual Analog Scale), consumption of rescue anti-emetics, and side effects in 24-hour timeframe. SPSS was be used to analyse the data, and the statistical significance was be determined at p < 0.05, using either Chi-square tests, ANOVA or Kruskal-Wallis tests.

Expected Outcomes: The research was decide on the most practical and cost-effective antiemetic to treat PONV prophylaxis in the Pakistani population to fill the gap in regional findings and help evidence-based medical practice to achieve protocol relief and perioperative results to improve patient satisfaction levels.