Comparison of Frequency of Postoperative Nausea and Vomiting with Blend of Metoclopramide and Dexamethasone Versus Dexamethasone Alone
DOI:
https://doi.org/10.51253/pafmj.v75iSUPPL-1.6785Keywords:
Dexamethasone, Metoclopramide, Post-operative nausea and vomitingAbstract
Objective: To compare the frequency of postoperative nausea and vomiting with combination of Intravenous metoclopramide and dexamethasone versus Intravenous dexamethasone alone in surgeries under General Anesthesia.
Study Design: Comparative prospective study
Place and Duration of Study: Anesthesia and Intensive Care department, Combined Military Hospital, Bahawalpur Pakistan, from Oct 2020-Apr 2021.
Methodology: A sample of 310 patients was collected through consecutive sampling. Patients were divided in two groups at random: Group A and Group B, by using lottery method. Group(A) patients were given combination of metoclopramide (10mg) and dexamethasone (8mg) Intravenous. Group(B) patients were given dexamethasone (8mg) Intravenous alone. After 24 hours, patients were evaluated for vomiting or nausea post-operatively.
Results: The mean of age of patients in study group A was 38.87±13.07 years and in B study group was 40.10±12.13 years. Out of these 310 patients, 177(57.10%) were male and 133(42.90%) were females with male to female ratio of ratio of 1.3:1. In my study, I have found that better nausea in 14(9.03%) group A patients compared to 31(20.0%) group B patients (p-value =0.006). Vomiting was found in 03(1.94%) group A patients and 13(8.39%) in group B patients (p-value=0.010).
Conclusion: This study concluded that combination of intravenous metoclopramide and dexamethasone is better as compared to intravenous dexamethasone alone in reducing nausea and vomiting post-operatively in patients receiving general anaesthesia.
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References
Cao X, White PF, Ma H. An update on the management of postoperative nausea and vomiting. J Anesth. 2017 Aug; 31(4): 617-626
Sizemore DC, Singh A, Dua A, et al.,. Postoperative Nausea. [Updated 2021 Apr 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK500029/
Son YG, Shin J, Ryu HG. Pneumonitis and pneumonia after aspiration. J Dent Anesth Pain Med. 2017; 17(1): 1-12
Jin Z, Gan TJ, Bergese SD. Prevention and Treatment of Postoperative Nausea and Vomiting (PONV): A Review of Current Recommendations and Emerging Therapies. Ther Clin Risk Manag. 2020; 16(10): 1305-17.
Dewinter G, Staelens W, Veef E, TeunkensW , De M V and Rex S. Simplified Algorithm For The Prevention Of Postoperative Nausea And Vomiting: A Before-And-After Study. Br. J. Anaesth.2018; 120(1): 156-63
Regasa T, Aweke Z, Neme D, Hailu S, Jemal B and Mekonen S Comparison of prophylactic dexamethasone, metoclopramide, and combination of dexamethasone and metoclopramide for prevention of post-operative nausea and vomiting for major gynaecological surgery. Int. J. Surg. Open 2020.27; 18-24
Veitía WEC, Martínez LL, Amable DT, et al.,. Combined therapy and prophylaxis in postoperative nausea and vomiting in laparoscopic surgery. Rev Cub Med Mil. 2019; 48(4): 855-874.
Ko-Iam W, Sandhu T, Paiboonworachat S, Pongchairerks P, Junrungsee S, Chotirosniramit et al.,l. A Metoclopramide, versus its combination with dexamethasone in the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy: a double-blind randomized controlled trial. J Med Assoc Thai. 2015 Mar; 98(3): 265-72
Elvir-Lazo OL, White PF, Yumul R and Cruz Eng H. Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review 2020, 9(Faculty Rev): 983
https://doi.org/10.12688/f1000research.21832.1
Roila F, Fatigoni S. New antiemetic drugs. Ann Oncol. 2006 Mar;17 Suppl 2:ii96-100.https://doi: 10.1093/annonc/mdj936
Spronk, I., Korevaar, J.C., Poos, R. et al.,. Calculating incidence rates and prevalence proportions: not as simple as it seems. BMC Public Health https://doi.org/10.1186/s12889-019-6820-3.
Atef, H.M., Ismail, S.A., Al-Touny, A. et al.,. Postoperative analgesia in children undergoing adenotonsillectomy under sevoflurane versus propofol-based anesthesia: a randomized controlled trial. Ain-Shams J Anesthesiol
https://doi.org/10.1186/s42077-019-0032-z
Al-Radeef MY, Abood SJ, Abdulsahib WK, Hamad SO. Comparing the Effect of Dexamethasone, Normal Saline, and Metoclopramide on Prevention of Postoperative Nausea, Vomiting and Pain in Patient Undergoing Laparoscopic Cholecystectomy or Open Appendectomy: A Randomized Clinical Trial. Open Access Maced J Med Sci.2019; 19(8): 139-44.
Henzi I, Walder B, Tramer MR. Dexamethasone for the prevention of postoperative nausea and vomiting: a quantitative systematic review. Anesth Analg 2000; 90(6): 186-94
Double-blind, dose-finding study of four intravenous doses of dexamethasone in the prevention of cisplatin-induced acute emesis. Italian Group for Antiemetic Research. J Clin Oncol. 1998; 16(9): 2937-42
Swaro S, Karan D, Banerjee A. Comparison of Palonosetron, Dexamethasone, and Palonosetron Plus Dexamethasone as Prophylactic Antiemetic and Antipruritic Drug in Patients Receiving Intrathecal Morphine for Lower Segment Cesarean Section. Anesth Essays Res. 2018; 12(2): 322-327
Wakamiya R, Seki H, Ideno S, Ihara N, Minoshima R, Watanabe K, Sato Y, Morisaki H. Effects of prophylactic dexamethasone on postoperative nausea and vomiting in scoliosis correction surgery: a double-blind, randomized, placebo-controlled clinical trial. Sci Rep. 2019 Feb 14; 9(1): 2119
Teshome D, Fenta E And Hailu S. Preoperative prevention and postoperative management of nausea and vomiting in resource limited setting: A systematic review and guideline. Niger J Clin Pract. 2020: 17(4): 10-17
Kang Y, Ku Ej, Jung Ig, Kang Mh, Choi Ys, Jung Hj. Dexamethasone And Post-Adenotonsillectomy Pain In Children: Double-Blind, Randomized Controlled Trial. Medicine (Baltimore). 2021; 100(2): E24122.
https://Doi:10.1097/Md.0000000000024122
Arumugam S, Woolley K, Smith R A.Comparison of Dexamethasone 4mg vs 8mg Doses in Total Joint Arthroplasty Patients: A Retrospective Analysis. Cureus; 12(9): 10295
W S, Abdalla E and Kamel E Z Intravenous dexamethasone combined with intrathecal atropine to prevent morphine-related nausea and vomiting after cesarean delivery: A randomized double-blinded study. 2019: 35(1): 65-70
Ashoor T, Kassim DY, Hasseb AM, Esmat IM. Effects of aprepitant /dexamethasone versus mirtazapine/dexamethasone on postoperative nausea and vomiting after laparoscopic sleeve gastrectomy: a randomized controlled trial Egypt. J. Anaesth https://doi:10.21203/rs.3.rs-107678/v1
Uchinami Y, Takikawa S, Takashima F, et al.,. Incidence of postoperative nausea and vomiting is not increased by combination of low concentration sevoflurane and propofol compared with propofol alone in patients undergoing laparoscopic gynecological surgery. JA Clin Rep. 2019;5(1):70
Alkaissi A and Dwikat M. Dexamethasone, Metoclopramide, and their combination for the prevention of postoperative nausea and vomiting in female patients with moderate-to-high risk for PONV undergoing Laparoscopic Surgery. J. Evolution Med. Dent. Sci; 6(10): 5353-5910
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