Introduction: Postoperative nausea and vomiting is one of the most important complications after anesthesia and surgery, with a relatively high incidence after middle ear surgery. Selective 5-HT3 antagonists are considered first line for prophylaxis, ondansetron being most commonly used agent and ramosetron being more potent and long acting.

Methods: 74 patients admitted to SSIMS&RC for middle ear surgeries, were divided into group RD and group OD. Group RD received ramosetron 0.3mg and dexamethasone 8mg whereas group OD received ondansetron 4mg and dexamethasone 8mg 30 minutes before the end of surgery.

The incidence of postoperative nausea, retching, vomiting and the requirement of rescue antiemetic was recorded over 0-6hrs and 6-24 hrs.

Results: The incidence of vomiting (p-0.027) and the requirement of rescue antiemetic(p-0.003) was significantly less in group which received the combination of ramosetron and dexamethasone when compared to the group which received ondansetron and dexamethasone. There was no statistical difference with regard to the incidence of nausea(p-0.183) and retching(p-0.286)  between both the groups during 0-6hrs postoperatively. During 6-24hrs postoperatively, there was no statistical difference between both the groups in terms of nausea (p-0.50), retching (p-0.50), vomiting(p-0.50) and requirement of rescue antiemetic.

Conclusion: We conclude by our study that the combination of ramosetron and dexamethasone is superior to ondansetron and dexamethasone for the prophylaxis of PONV in middle ear surgeries.

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Dr Nishant Agrawal

Postgraduate, Dept. of Anaesthesia, S S Institute of Medical Science and Research Centre, Davangere, Karnataka