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A Comparative Clinical Study of Methylprednisolone with Ondansetron versus Ramosetron in Preventing Postoperative Nausea and Vomiting in Patients Undergoing Middle-Ear Surgeries

BACKGROUND: One of the most troublesome complications after middle-ear surgeries has been postoperative nausea and vomiting (PONV). A notable decrease in PONV has been observed with the use of 5-hydroxytryptamine type 3 receptor antagonists and glucocorticoids. AIM: This study aimed to evaluate the...

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Autores principales: Somsundar, R. G., Shivakumar, G., Santhosh, M. C. B., Krishna, K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9558658/
https://www.ncbi.nlm.nih.gov/pubmed/36249137
http://dx.doi.org/10.4103/aer.aer_2_22
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author Somsundar, R. G.
Shivakumar, G.
Santhosh, M. C. B.
Krishna, K.
author_facet Somsundar, R. G.
Shivakumar, G.
Santhosh, M. C. B.
Krishna, K.
author_sort Somsundar, R. G.
collection PubMed
description BACKGROUND: One of the most troublesome complications after middle-ear surgeries has been postoperative nausea and vomiting (PONV). A notable decrease in PONV has been observed with the use of 5-hydroxytryptamine type 3 receptor antagonists and glucocorticoids. AIM: This study aimed to evaluate the effectiveness of the combination of intravenous methylprednisolone and ondansetron with ramosetron alone in preventing PONV in patients undergoing middle-ear surgeries. SETTINGS AND DESIGN: This was a prospective, randomized, double-blind study that comprised sixty patients in the age group of 18–60 years belonging to the American Society of Anesthesiologists (ASA) physical status classification I or II and undergoing middle-ear surgery. MATERIALS AND METHODS: With the help of computer-generated randomization table, sixty patients in the age group of 18–60 years belonging to ASA physical status classification I or II and undergoing middle-ear surgery were randomly allotted 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 ramosetron 0.3 mg (near the end of surgery) (Group R, n = 30). In both the groups, the incidence of PONV was studied. STATISTICAL ANALYSIS: Chi-square test or Fisher's exact test was utilized to analogize the categorical variables. Independent t-test was utilized to analogize the continuous variables. RESULTS: In the first 2 h after the surgery, the difference between the two groups regarding the incidence of PONV was insignificant. Between 2 h and 24 h, the incidence of nausea was lowered significantly in the group MO compared to the group R (P = 0.01). Between 24 h and 48 h, the incidence of nausea was more in group R compared to the combination therapy group, which was statistically significant. CONCLUSION: The combination therapy is better than ramosetron alone for the prevention of PONV after middle-ear surgery. Therefore, we advocate a combination of methylprednisolone and ondansetron for prophylaxis for PONV in middle-ear surgeries.
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spelling pubmed-95586582022-10-14 A Comparative Clinical Study of Methylprednisolone with Ondansetron versus Ramosetron in Preventing Postoperative Nausea and Vomiting in Patients Undergoing Middle-Ear Surgeries Somsundar, R. G. Shivakumar, G. Santhosh, M. C. B. Krishna, K. Anesth Essays Res Original Article BACKGROUND: One of the most troublesome complications after middle-ear surgeries has been postoperative nausea and vomiting (PONV). A notable decrease in PONV has been observed with the use of 5-hydroxytryptamine type 3 receptor antagonists and glucocorticoids. AIM: This study aimed to evaluate the effectiveness of the combination of intravenous methylprednisolone and ondansetron with ramosetron alone in preventing PONV in patients undergoing middle-ear surgeries. SETTINGS AND DESIGN: This was a prospective, randomized, double-blind study that comprised sixty patients in the age group of 18–60 years belonging to the American Society of Anesthesiologists (ASA) physical status classification I or II and undergoing middle-ear surgery. MATERIALS AND METHODS: With the help of computer-generated randomization table, sixty patients in the age group of 18–60 years belonging to ASA physical status classification I or II and undergoing middle-ear surgery were randomly allotted 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 ramosetron 0.3 mg (near the end of surgery) (Group R, n = 30). In both the groups, the incidence of PONV was studied. STATISTICAL ANALYSIS: Chi-square test or Fisher's exact test was utilized to analogize the categorical variables. Independent t-test was utilized to analogize the continuous variables. RESULTS: In the first 2 h after the surgery, the difference between the two groups regarding the incidence of PONV was insignificant. Between 2 h and 24 h, the incidence of nausea was lowered significantly in the group MO compared to the group R (P = 0.01). Between 24 h and 48 h, the incidence of nausea was more in group R compared to the combination therapy group, which was statistically significant. CONCLUSION: The combination therapy is better than ramosetron alone for the prevention of PONV after middle-ear surgery. Therefore, we advocate a combination of methylprednisolone and ondansetron for prophylaxis for PONV in middle-ear surgeries. Wolters Kluwer - Medknow 2022 2022-06-27 /pmc/articles/PMC9558658/ /pubmed/36249137 http://dx.doi.org/10.4103/aer.aer_2_22 Text en Copyright: © 2022 Anesthesia: Essays and Researches https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Somsundar, R. G.
Shivakumar, G.
Santhosh, M. C. B.
Krishna, K.
A Comparative Clinical Study of Methylprednisolone with Ondansetron versus Ramosetron in Preventing Postoperative Nausea and Vomiting in Patients Undergoing Middle-Ear Surgeries
title A Comparative Clinical Study of Methylprednisolone with Ondansetron versus Ramosetron in Preventing Postoperative Nausea and Vomiting in Patients Undergoing Middle-Ear Surgeries
title_full A Comparative Clinical Study of Methylprednisolone with Ondansetron versus Ramosetron in Preventing Postoperative Nausea and Vomiting in Patients Undergoing Middle-Ear Surgeries
title_fullStr A Comparative Clinical Study of Methylprednisolone with Ondansetron versus Ramosetron in Preventing Postoperative Nausea and Vomiting in Patients Undergoing Middle-Ear Surgeries
title_full_unstemmed A Comparative Clinical Study of Methylprednisolone with Ondansetron versus Ramosetron in Preventing Postoperative Nausea and Vomiting in Patients Undergoing Middle-Ear Surgeries
title_short A Comparative Clinical Study of Methylprednisolone with Ondansetron versus Ramosetron in Preventing Postoperative Nausea and Vomiting in Patients Undergoing Middle-Ear Surgeries
title_sort comparative clinical study of methylprednisolone with ondansetron versus ramosetron in preventing postoperative nausea and vomiting in patients undergoing middle-ear surgeries
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9558658/
https://www.ncbi.nlm.nih.gov/pubmed/36249137
http://dx.doi.org/10.4103/aer.aer_2_22
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