Chilkoti Geetanjali T, Nandanan Janaki, Saxena Ashok Kumar, Seth Varun, Kaur Navneet, Maurya Prakriti
Department of Anesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahdara, Delhi, India.
Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahdara, Delhi, India.
J Anaesthesiol Clin Pharmacol. 2025 Jan-Mar;41(1):84-89. doi: 10.4103/joacp.joacp_357_23. Epub 2024 Dec 16.
Ondansetron and dexamethasone combination is effective for prophylaxis against postoperative nausea and vomiting (PONV). Ondansetron, when compared to dexamethasone, is known to cause more adverse effects and is relatively expensive. The present study evaluated the efficacy of standard dose and low dose ondansetron, i.e. 100 μg/kg and 50 μg/kg, respectively, with dexamethasone 8 mg for PONV prophylaxis in laparoscopic cholecystectomy (LC).
After the approval from the Institutional Ethics Committee-Human Research [IEC-HR] and prospective CTRI registration, this randomized, double-blind interventional study was conducted following informed consent from each participant. Patients aged 18-65 years of either sex, with ASA physical status I or II, undergoing LC under general anesthesia, were included and divided into groups C and L. Patients in groups C and L received 100 μg and 50 μg of ondansetron, respectively, in combination with 8 mg dexamethasone. The incidence of PONV in first 6 hrs, PONV score, rescue antiemetic consumption, rescue analgesia, and hemodynamic parameters were recorded.
A total of 110 patients were included with 55 in each group. Incidence of PONV in the first 6 hours was found to be higher in 1-2 hour- and 2-3-hour time intervals in group L; but was significant only at 1-2-hour time interval ( < 0.05). Proportion of patients needing rescue antiemetic in the first 6 hours was higher in group L but was not statistically significant.
We observed that 50 μg/kg combination of ondansetron was associated with higher incidence of post operative nausea in the immediate postoperative period than 100 μg/kg dose; however, no significant difference was observed in incidence of post-operative vomiting between two doses following LC.
昂丹司琼与地塞米松联合用药对预防术后恶心呕吐（PONV）有效。与地塞米松相比，昂丹司琼已知会引起更多不良反应且相对昂贵。本研究评估了标准剂量和低剂量昂丹司琼（分别为100μg/kg和50μg/kg）与8mg地塞米松联合用于腹腔镜胆囊切除术（LC）中预防PONV的疗效。
经机构伦理委员会-人体研究[IEC-HR]批准并进行前瞻性CTRI注册后，在获得每位参与者的知情同意后进行了这项随机、双盲干预研究。纳入年龄在18-65岁、性别不限、ASA身体状况为I或II、在全身麻醉下接受LC的患者，并分为C组和L组。C组和L组患者分别接受100μg和50μg昂丹司琼，同时联合8mg地塞米松。记录术后6小时内PONV的发生率、PONV评分、补救性止吐药的使用、补救性镇痛以及血流动力学参数。
共纳入110例患者，每组55例。L组在术后1-2小时和2-3小时时间段内，术后6小时内PONV的发生率较高；但仅在1-2小时时间段有统计学意义（<0.05）。L组在术后6小时内需要补救性止吐药的患者比例较高，但无统计学意义。
我们观察到，与100μg/kg剂量相比，50μg/kg昂丹司琼联合用药在术后即刻与更高的术后恶心发生率相关；然而，LC术后两剂量之间的术后呕吐发生率无显著差异。
