Title: Is Dexamethsone as Effective as Granisetron in Prevention of Post Operative Nausea and Vomiting in Gynecologic Laparoscopic Surgeries?

Authors: Mohamed A Youssry MD, Tamer Nabil Ibrahim MD

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i2.71

Abstract

Objective: The aim of this study is to compare the antiemetic effects of intravenous granisetron 40mcg/kg versus 8 mg dexamethasone for prevention of postoperative nausea and vomiting (PONV) in patients undergoing gynaecologic laparoscopic surgeries.

Subject and Methods: In this prospective comparative study,  a total of 64 women recruited for the study who underwent elective abdominal gynaecologic laparoscopic procedures under general anesthesia with endotracheal intubation, 34 patients were assigned to granisetron group (A) and 30 patients were assigned to dexamethasone group (B). Preoperatively all patients were subjected to a thorough medical history, physical examination, laboratory investigations. Postoperatively patients were assessed according to nausea and vomiting score, hemodynamic changes, and the need for rescue antiemetics.

Results: After 6 hours and up to 24 hours postoperatively, 6 (20%) patients experienced nausea in group (B) compared to 2 (5.9%) patients in group (A) and 5 (16.7%) patients experienced vomiting in group (B) compared to only one (2.9%) patient in group (A) which was significant (P= 0.05, 0.046) respectively. Anti-emetics were used in 5(16.7%) patients in group (B) compared to only one (2.9%) patient in group (A) which was statistically significant (p= 0.045).

Conclusion: Dexamethasone is as effective as granisetron in controlling PONV during the first six hours postoperatively, however during rest of the first day granisetron showed more efficient control of PONV than dexamethasone. On the other hand, dexamethasone could be a good second alternative to granisetron particularly for economic basis in patients undergoing laparoscopic gynaecologic operations despite its expected side effects.

Keywords: dexamethasone, laparoscopic surgeries, granisetron, antiemetics.

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Mohamed A Youssry MD

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