International Journal of Medical Anesthesiology
2021, Vol. 4, Issue 3, Part B
A comparative clinical study of methylprednisolone with ondansetron versus methylprednisolone with ramosetron in preventing postoperative nausea and vomiting in patients undergoing middle ear surgeries
Author(s): Dr. Krishna K, Dr. Santhosh MCB and Dr. Shivakumar G
Abstract: Background: Postoperative nausea and vomiting (PONV) is one of the most unpleasant complications of anaesthesia and is more common following middle ear surgeries. Ondansetron, a 5-HT3 (5-hydroxytryptamine type 3) receptor antagonist provides significant reduction in early PONV. The other 5-HT3 antagonist ramosetron, with long duration of action, has been found to be more effective than ondansetron in reducing the early as well as delayed PONV. The antiemetic effects of glucocorticoids (dexamethasone and methylprednisolone) are well documented. So, the present study was designed to compare the efficacy of the combination of intravenous methylprednisolone and ondansetron with combination of intravenous methylprednisolone and ramosterone in preventing postoperative nausea and vomiting in patients undergoing middle ear surgeries.
Methods: Sixty patients in the age group of 18-60 years, with American Society of Anaesthesiologists (ASA) physical status classification I or II, undergoing middle ear surgery were randomly allocated to receive a combination of methylprednisolone 40 mg (given at the beginning of surgery) and ondansetron 4 mg (given near the end of surgery) (group MO, n=30) or combination of intravenous methylprednisolone 40 mg and ramosetron 0.3 mg (near the end of surgery) (group R, n=30), by a computer-generated randomization table. Incidence of PONV in the both groups were studied and compared.
Results: There was no significant difference in PONV between the groups in the first 2 h after the surgery. Between 2 and 24 h, the incidence of nausea was significantly lower in the methylprednisolone and ondansetron group compared to the methylprednisolone and ramosetron group (P=0.01). Between 24 and 48 h, there was no difference between the two groups with respect to incidence of nausea and vomiting.
Conclusion: The combination of methylprednisolone and ondansetron is superior to combination of methylprednisolone and ramosetron for prevention of PONV after middle ear surgery especially in treatment of early PONV. Therefore, we recommend combination of methylprednisolone and ondansetron for prophylaxis for PONV in middle ear surgeries.
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How to cite this article:
Dr. Krishna K, Dr. Santhosh MCB, Dr. Shivakumar G. A comparative clinical study of methylprednisolone with ondansetron versus methylprednisolone with ramosetron in preventing postoperative nausea and vomiting in patients undergoing middle ear surgeries. Int J Med Anesthesiology 2021;4(3):78-81. DOI: 10.33545/26643766.2021.v4.i3b.282