Abstract :
Background: Postoperative nausea and vomiting (PONV) is a frequent complication following general anaesthesia, particularly in patients undergoing Ear, Nose, and Throat (ENT) surgeries. Vestibular stimulation and middle ear manipulation increase the risk of PONV. Ondansetron and dexamethasone are commonly used antiemetic agents, and combination therapy may improve prophylaxis.Objectives: To compare the efficacy of ondansetron, dexamethasone, and their combination in preventing postoperative nausea and vomiting in patients undergoing elective ENT surgeries under general anaesthesia.Materials and Methods: This prospective, randomized, double-blinded study included 104 adult patients with American Society of Anaesthesiologists physical status I–II scheduled for elective ENT surgeries. Patients were randomly allocated to receive intravenous ondansetron 4 mg, dexamethasone 8 mg, or a combination of ondansetron 4 mg and dexamethasone 8 mg before induction of anaesthesia. The incidence of nausea and vomiting was assessed during the early (0–1 hour) and late (1–6 hours) postoperative periods, and the requirement for rescue antiemetic therapy was recorded.Results: The overall incidence of vomiting was significantly lower in the combination group (14%), compared with ondansetron alone (53%) and dexamethasone alone (60%). 33% patients in ondansetron group, 45% in dexamethasone group and 3% in combination group required rescue antiemetic therapy. Ondansetron alone showed reduced efficacy against late postoperative nausea and vomiting, while dexamethasone alone was less effective during the early postoperative period.Conclusion: Combination prophylaxis with ondansetron and dexamethasone provides superior control of postoperative nausea and vomiting compared with either agent alone in patients undergoing ENT surgeries under general anaesthesia safely.
Keyword :
Postoperative Nausea and Vomiting, Ondansetron, Dexamethasone, Otolaryngologic Surgical Procedures, General Anesthesia, Antiemetics