Dexmedetomidine versus dexamethasone adding to ondansetron for prophylaxis against postoperative nausea and vomiting after laparoscopic cholecystectomy

Abstract

Background: Postoperative nausea and vomiting (PONV) remain a major issue even with improvements in pharmaceutical and anesthetic management used to avoid it. Although laparoscopic procedures facilitate a quicker recovery, they also result in a higher incidence of PONV than other surgical procedures.Aim of the work: To contrast antiemetic impacts among dexmedetomidine and ondansetron in the 1st group against dexamethasone and ondansetron in the 2nd group. Methods: This comparative work was performed on 70 females ranging in age from 18 to 65 years, American Society of Anesthesiologists (ASA) I or II, who were planned for elective laparoscopic cholecystectomy surgeries. Participants had been assigned at random into two groups equally: Group I (Dexmedetomidine group): received dexmedetomidine 0.5 ug/kg + Ondansetron 4mg and Group II (Dexamethasone group): received ondansetron 4mg + dexamethasone 8 mg. Results:Nausea by NRS at 0 hr. was a substantially decrease in dexmedetomidine group contrasted todexamethasone group (p< 0.001). Ramsay sedation score and Rhodes Index were significantly difference between both groups (p< 0.001). Nausea at 0 hr, pain at 0 hr. and at 1 hr. had a substantially greater risk in group 2 contrasted to in group 1 (p< 0.001**). A positive correlation with HR and MAP was existed at 30 min, 60 min and at the end of the operation, nausea at 0 min, pain at 0 min and complications. Also, a negative correlation was existed with the Ramsay sedation score. The dexmedetomidine group showed lower nausea at 0 hr and post-operative pain at 0 hr and at 1 hr than dexamethasone group. Conclusion: Dexmedetomidine has a similar impact to dexamethasone in decreasing the occurrence and intensity of PONV. Furthermore, dexmedetomidine surpasses dexamethasone in diminishing postoperative pain and overall analgesic use following laparoscopic cholecystectomy, without any negative consequences.