Dexasone and metoclopramide vs. granisetron in the prevention of postoperative nausea and vomiting

Abstract

Introduction Postoperative nausea and vomiting (PONV) is one of the most common postoperative complications. The incidence in adult population is 20–30%, and it can be up to 80% in high-risk population such as gynecological and laparoscopic surgeries. The objective of this study is to compare the efficiency of the combination therapy in comparison with monotherapy in the prevention of PONV in gynecological and laparoscopic surgeries.

Methods An observational prospective cohort study was conducted on a sample of 64 patients (32 patients per group) treated postoperatively at the Gynecology and Obstetrics Ward of GH Subotica, in the period from January–March 2017. The anesthesiologist in charge administered the combination of dexasone and metoclopramide or granisetron in monotherapy according to protocol to patients for prevention of PONV.

Results The demographic characteristics of patients are homogenous and show a statistically significant difference only in the characteristics of length of smoker status and maximum intra-abdominal pressure during surgery. The total incidence of postoperative nausea in the fifth, 15th and 60th minute was 15.6%, 17.2% and 18.7% respectively, and in the fourth, eighth, 12th, and 24th postoperative hour it was 12.5%, 7.8%, 10.9%, and 6.2%, respectively. The incidence of postoperative vomiting in the fifth, 15th, and 60th minute was 1.6%, 4.7%, and 4.7%, respectively, and in the fourth, eighth, 12th, and 24th postoperative hour it was 1.6%, 3.2%, 1.6%, and 1.6%, respectively.

Conclusion The study proved that the combination effect of dexasone and metoclopramide is not inferior compared to monotherapy with granisetron.

Keywords: postoperative; nausea; vomiting