Efficacy of risk score dependent antiemetic regimens in reduction of post operative nausea and vomiting
Journal Title: Indian Journal of Clinical Anaesthesia - Year 2018, Vol 5, Issue 2
Abstract
Postoperative nausea and vomiting PONV is a common complication after anaesthesia Although self limiting and non fatal it can cause significant morbidity and delay discharge The intention of doing this study was to evaluate the accuracy of three risk scores in predicting PONV and to evaluate the efficacy of different therapeutic regimens based on the risk score in the reduction of PONVMaterials and Methods In this prospective randomized double blinded study 180 patients between 1860 years age group belonging to ASA 1 and ASA 2 categories coming for elective surgeries under general anaesthesia of 14hrs duration irrespective of the type of surgery were scored preoperatively for postoperative nausea and vomiting using APFEL KOIVURANTA PALAZZO and EVANS scoring systems into low risk and high risk groups Low risk group ie Group O consisting of 60 patients inj ondansetron 4mg was given intravenously 30 minutes before administration of reversal agent High risk group was further categorized into Group M and Group D consisting of 60 patients each based on the intervention to assess the efficacy of the drugs used in these two groups Group M patient received injondansetron 4mginjmetoclopramide 10mg intravenously IV 30 minutes before administration of reversal agent Group D patient received inj dexamethasone 4mg IV at induction and injondansetron 4mg IV 30 minutes before administration of reversal agent After the procedure patients were observed for any retching nausea or vomiting in postanaesthesia care unit and up to 24 hours Rescue treatment from a drug of different pharmacological group was administered if requiredResults Area under the curve AUC and the corresponding 95 confidence intervals for the scores drawn from Receiver operator characteristic ROC curves were Apfel 06154 050470072618 Koivuranta 06154 050470072618 Palazzo Evans 06443 054096074764 And a complete response of 7167 was observed in Group O 7667 in Group M and 90 in Group D Thus we concluded that all the three scores had moderate accuracy in predicting the risk of PONV and ondansetrondexamethasone combination was found to be superior to ondansetron metoclopramide combination in high risk patientsKeywords General anaesthesia Scoring systems Ondansetron Dexamethasone Metoclopromide
Authors and Affiliations
Renuka R. , Radhika D. Dhandal
Keywords
Related Articles
- EP ID EP476447
- DOI 10.18231/2394-4994.2018.0034
- Views 72
- Downloads 0
Comparison of different methods of general anaesthesia for controlled hypotension in functional endoscopic sinus surgery (FESS)
Introduction and Aims Functional Endoscopic Sinus Surgery FESS is minimal invasive technique for management of chronic sinusitis Controlled hypotension is required in FESS for bloodless field better visualization reduce...
“Attenuation of hemodynamic response to laryngoscopy and endotracheal intubation - comparison of fentanyl, esmolol and metoprolol” in normotensive individuals
Introduction: Direct laryngoscopy and endotracheal intubation is an intrinsic component of general anaesthetic technique. It is a powerful stimulus which may evoke a plethora of sympathoadrenal stress responses. Various...
A comparative study between dexmedetomidine, clonidine and magnesium sulfate in attenuating hemodynamic response to laryngoscopy and intubation – a randomised study
Introduction: The stress responses to laryngoscopy comprising of elevation in heart rate and rise in systolic and diastolic pressure are well known. The potential for life threatening complications associated with these...
Etomidate versus Propofol as induction agent in patients undergoing Endoscopic Retrograde Cholangiopancreaticogram (ERCP)
Background: Endoscopic retrograde pancreaticogram (ERCP) requires patient to be sedated and pain free in prone position. Propofol sedation may cause cardiorespiratory depression. Etomidate is a good alternative with stab...
Postoperative delirium – Review Article
Postoperative delirium is a common but often a missed complication following major surgery in elderly patients. Early diagnosis, treatment with non-pharmacological means, and drug treatment reduces complications, so also...