Comparing the effect of ondansetron–dexamethasone and metoclopramide–dexamethasone on postoperative nausea and vomiting after gynecological laparoscopy: A randomized double-blind clinical trial

Document Type : Original Article

Authors
Arvin Barzanji 1
Karim Nasseri 2
Shahram Sadeghi 3
Mahsa Ardalan 4
Bijan Nouri 5
Khadijeh Daseh 6
1 Department of Anesthesiology, Faculty of Paramedical Sciences, Kurdistan University of Medical Sciences, Sanandaj, Iran
2 Department of Anesthesiology, Faculty of Medicine, Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
3 Spiritual Health Research Center, Health Development Research Institute, Kurdistan University of Medical Sciences, Sanandaj, Iran
4 Kurdistan University of Medical Sciences, Sanandaj, Iran
5 Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
6 Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
Abstract
Background: Nausea and vomiting is a common complication after gynecological surgeries, especially laparoscopy, which can lead to discomfort and restlessness in the patients. The aim of the study was to compare the effect of ondansetron–dexamethasone and metoclopramide–dexamethasone on postoperative nausea and vomiting following gynecological laparoscopy. Materials and Methods: In this double-blind clinical trial, 68 females scheduled for gynecological laparoscopy and age range of 18–40 years were randomly divided into two groups. Group OD received ondansetron 4 mg plus dexamethasone 8 mg and group MD received metoclopramide 10 mg plus dexamethasone 8 mg, 15 min before the end of surgery. The incidence of nausea and vomiting and need for rescue medication was assessed during the recovery period, as well as at 2, 4, 6, 12, and 24 h after surgery. The data were analyzed using STATA software version 12 and a significance level of <0.05 was considered in this research. Results: The incidence of nausea in ondansetron and metoclopramide groups was 23.3% and 33.3%, respectively, and the frequency of vomiting was 10% and 16.6%, respectively, which showed no significant difference (P > 0.05). The highest incidence of nausea and vomiting in patients belonged to the metoclopramide group inside 4–6 h after surgery. Conclusion: Our study showed that no significant difference was observed in the incidence of nausea and vomiting between ondansetron–dexamethasone and metoclopramide–dexamethasone groups following laparoscopic gynecological surgery; however, the number of patients with nausea and vomiting was lower in the ondansetron–dexamethasone group.

Keywords

1.
Cao X, White PF, Ma H. An update on the management of postoperative nausea and vomiting. J Anesth 2017;31:617-26.  Back to cited text no. 1
    
2.
Grape S, Usmanova I, Kirkham K, Albrecht E. Intravenous dexamethasone for prophylaxis of postoperative nausea and vomiting after administration of long-acting neuraxial opioids: A systematic review and meta-analysis. Anaesthesia 2018;73:480-9.  Back to cited text no. 2
    
3.
Guo W, Ding J, Jin X, Li G. Effect of cerebral oxygen saturation on postoperative nausea and vomiting in female laparoscopic surgery patients. Medicine (Baltimore) 2017;96:e8275.  Back to cited text no. 3
    
4.
Le TP, Gan TJ. Update on the management of postoperative nausea and vomiting and postdischarge nausea and vomiting in ambulatory surgery. Anesthesiol Clin 2010;28:225-49.  Back to cited text no. 4
    
5.
Won YJ, Yoo JY, Chae YJ, Kim DH, Park SK, Cho HB, et al. The incidence of postoperative nausea and vomiting after thyroidectomy using three anaesthetic techniques. J Int Med Res 2011;39:1834-42.  Back to cited text no. 5
    
6.
Bilgin TE, Birbicer H, Ozer Z, Doruk N, Tok E, Oral U. A comparative study of the antiemetic efficacy of dexamethasone, ondansetron, and metoclopramide in patients undergoing gynecological surgery. Med Sci Monit 2010;16:R336-41.  Back to cited text no. 6
    
7.
Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Cohen NH, Young WL. Miller's Anesthesia E-Book. Canada: Elsevier Health Sciences; 2014.  Back to cited text no. 7
    
8.
Wang XX, Zhou Q, Pan DB, Deng HW, Zhou AG, Huang FR, et al. Dexamethasone versus ondansetron in the prevention of postoperative nausea and vomiting in patients undergoing laparoscopic surgery: A meta-analysis of randomized controlled trials. BMC Anesthesiol 2015;15:118.  Back to cited text no. 8
    
9.
Fujii Y. Prophylaxis of postoperative nausea and vomiting in patients scheduled for breast surgery. Clin Drug Investig 2006;26:427-37.  Back to cited text no. 9
    
10.
Massad IM, Mohsen WA, Basha AS, Al-Zaben KR, Al-Mustafa MM, Alghanem SM. A balanced anesthesia with dexmedetomidine decreases postoperative nausea and vomiting after laparoscopic surgery. Saudi Med J 2009;30:1537-41.  Back to cited text no. 10
    
11.
Farhat K, Pasha AK, Kazi WA. Comparison of ondansetron and metoclopramide for PONV prophylaxis in laparoscopic cholecystectomy. J Anesthe Clinic Res 2013;4:2.  Back to cited text no. 11
    
12.
Jacobson TZ, Duffy JM, Barlow DH, Farquhar C, Koninckx PR, Olive D. WITHDRAWN: Laparoscopic surgery for subfertility associated with endometriosis. Cochrane Database Syst Rev 2014;(1):CD001398.  Back to cited text no. 12
    
13.
Safae M, Safi S. Evaluation of effect of ondansetron on nausea and vomiting after elective cholecystectomy surgery in women older than 40 years. J Isfahan Med Sch 2011;29:(149): 1021-1027.  Back to cited text no. 13
    
14.
Goodman L, Hardman J, Limbird L. Goodman and Gilman's The Pharmacological Basis of Therapeutics. New York: McGraw-Hill; 2011.  Back to cited text no. 14
    
15.
Isazadehfar K, Entezariasl M, Shahbazzadegan B, Nourani Z, Shafaee Y. The comparative study of ondansetron and metoclopramide effects in reducing nausea and vomiting after laparoscopic cholecystectomy. Acta Med Iran 2017;55:254-8.  Back to cited text no. 15
    
16.
Dabbous AS, Jabbour-Khoury SI, Nasr VG, Moussa AA, Zbeidy RA, Khouzam NE, et al. Dexamethasone with either granisetron or ondansetron for postoperative nausea and vomiting in laparoscopic surgery. Middle East J Anaesthesiol 2010;20:565-70.  Back to cited text no. 16
    
17.
Gan TJ, Coop A, Philip BK. A randomized, double-blind study of granisetron plus dexamethasone versus ondansetron plus dexamethasone to prevent postoperative nausea and vomiting in patients undergoing abdominal hysterectomy. Anesth Analg 2005;101:1323-9.  Back to cited text no. 17
    
18.
Sahabi SM, Alereza H, Alijanpore E, Banihashem N, Hassannasab B, Seify S. Comparison of dexamethazone and ondansetron with dexamethazone and metoclopramidein preventation of post â operative nausea and vomiting. Med J Mashhad Univ Med Sci 2010;53:73-8.  Back to cited text no. 18
    
19.
Sane S, Hasanlui MV, Abbasivash R, Mahoori A, Hashemi ST, Rafiei F. Comparing the effect of intravenous dexamethasone, intravenous ondansetron, and their combination on nausea and vomiting in cesarean section with spinal anesthesia. Adv Biomed Res 2015;4:230.  Back to cited text no. 19
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20.
Schulz KF, Altman DG, Moher D; Group C. CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. Trials 2010;11:32.  Back to cited text no. 20
    
21.
Kaki AM, Abd El-Hakeem EE. Prophylaxis of postoperative nausea and vomiting with ondansetron, metoclopramide, or placebo in total intravenous anesthesia patients undergoing laparoscopic cholecystectomy. Saudi Med J 2008;29:1408-13.  Back to cited text no. 21
    
22.
Sandhu T, Tanvatcharaphan P, Cheunjongkolkul V. Ondansetron versus metoclopramide in prophylaxis of nausea and vomiting for laparoscopic cholecystectomy: A prospective double-blind randomized study. Asian J Surg 2008;31:50-4.  Back to cited text no. 22
    
23.
Yeasmeen S, Yasmin R, Akhtaruzzaman A, Khatun US. Intravenous granisetron, ondansetron and metoclopramide in the prevention and treatment of post operative nausea and vomiting after laparoscopic cholecystectomy – A comparative study. J Bangladesh Soc Anaesthesiol 2006;19:20-27.  Back to cited text no. 23
    
24.
Mortazavi Y, Nikbakhsh N, Alijanpour E, Rabiee O, Khalilpour A, Mortazavi S. Effect of metoclopramide and ondansetrone plus dexamethason on postoperative nausea and vomiting in cholecystectomy laparoscopic surgery. J Gorgan Univ Med Sci 2014;16:9-13.  Back to cited text no. 24
Advanced Biomedical Research
Volume 2022, May
May 2022
Pages 1-6