Study of efficacy of Propofol, Ondansetron and Dexamethasone in prevention of post operative nausea & vomiting (PONV) following thyroidectomy

Abstract

Introduction: Post operative nausea and vomiting is one of the most common and annoying problem after general anesthesia resulting in patient discomfort, delaying discharge from recovery unit and may be at time dangerous resulting in pulmonary aspiration syndrome. Patients undergoing thyroid surgeries are at high risk for development of PONV with reporting incidence of 63% to 84%. We compare the efficacy of propofol, Ondansetron and dexamethasone to prevent PONV. Material and Methods: 60 adult patients undergoing elective partial or total thyroidectomy were placed in 3 groups (20 patients in each group)  Group 1 : Propofol 0.5 mg/kg (15 minutes before reversal)  Group 2 : Ondansetron 8 mg (15 minutes before induction)  Group 3 : Dexamethasone 10 mg (15 minutes after induction) Postoperatively all patients were assessed for the incidence of nausea, vomiting, vital parameters, pain and sedation score, occurrence of sore throat, requirement of rescue antiemetic and other complications for every 4 hours for 24 hours except during sleep. Results: Occurrence of PONV was high in group 3 (10%) during first 4 hours postoperatively as compared to other two groups. The entire three groups had similar efficacy in preventing PONV during 4-8 hours postoperatively. Between 8 to 20 hours the incidence is high in group 1 and 2 as compared to group 3.Complete response to PONV in group 3 was found during 12-24 hours while in group 1 and 2 in 20-24 hours postoperatively. Group 3 found to be the most effective in our study. Conclusion: Overall incidence of PONV in the first 24 hour period was 35% in group 1, 25% in group 2 and 20% in group 3. Stastically significant difference in the incidence of PONV was noted between group 3 and group 1 & 2. Group 3 found to be the most effective in our study. Delayed emesis is better controlled with Dexamethasone compared with other groups. All three groups found to be effective in preventing PONV as a complete response in later part of post operative period.