PROPHYLACTIC THERAPY WITH COMBINED ONDANSETRON AND DEXAMETHASONE FOR PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING AFTER MIDDLE EAR SURGERY

Abstract

Postoperative nausea and vomiting is a common problem after surgery with potentially serious medical complications such as aspiration pneumonia, dehydration and wound rupture. It may delay discharge from hospital with obvious economic consequences, and at the very least is distressing to the patients. There is no one distinct stimulus for PONY. PONY is multifactorial and depends on patients characteristics, anaesthetic agents, type of surgery and postoperative factors. Higher incidence of PONV was reported in patients under- going middle ear surgery. This work was carried to compare the efficacy of ondansetron plus dexamethasone with each drud alone in prevention of PONV after middle ear surgery. This study was carried out on 80 patients undergoing middle ear surgery ( ASA ) type I and II. they were allocated into : Control group : 20 patients received 5 ml normal saline 0.9% (placebo) before induction. Study group : 60 patients received prophylactic antiemetics just before induction and divided into 3 equal subgroups : Subgroup I: 20 patients received 4 mg ondansetron I.V. Subgroup II: 20 patients received 8 mg dexamethasone LV. Subgroup III : 20 patients received 4 mg ondansetron and 8 • mg dexamethasone I.V.