Comparative study of dexamethasone and ondansetron for prophylaxis of postoperative nausea and vomiting in laparoscopic gynecologic surgery

OBJECTIVE: To compare intravenous dexamethasone and ondansetron for the prophylaxis of postoperative nausea and vomiting (PONV), a main complaint that affects almost 40%-75% of patients undergoing laparoscopic gynecologic surgery. METHODS: In a prospective study, 93 women were divided into 3 groups receiving 4mg of dexamethasone, 8mg of dexamethasone, or 4mg of ondansetron. PONV score was used for assessment during the first 24hours after surgery. RESULTS: The incidence of PONV during the 24-hour postoperative period was highest in the ondansetron group (61%). In the first 3hours, the incidence of PONV in the ondansetron group was also higher: 51.6% as compared with 22.6% and 36.6% in the dexamethasone 4mg and 8mg groups, respectively. The overall incidence of PONV was highest in the first 3hours as compared with later time periods, and there was a linear trend in decreasing PONV among the groups (P=0.017). In the dexamethasone 4mg group, the request for a rescue antiemetic was significantly lower: 0% as compared with 6.7% and 16.1% in the dexamethasone 8mg and ondansetron 4mg groups, respectively. CONCLUSION: Dexamethasone was found to be an efficacious and cost-effective drug for the prophylaxis of PONV.