COMPARISON OF ONDANSETRON WITH ONDANSETRON PLUS DEXAMETHASONE IN THE PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING

The purpose of this double-blind, randomized study was to compare the effectiveness of ondansetron plus saline versus ondansetron plus dexam ethasone in the prevention of postoperative nausea and vomiting. Of 18 0 women having general anesthesia for major gynecologic surgery, 89 re ceived intravenous ondansetron, 4 mg, plus saline (Group 1) and 91 rec eived intravenous ondansetron, 4 mg, plus dexamethasone 8 mg (Group 2) during their operation. A complete response, defined as no emesis and no need for rescue antiemetic during the 24-h postoperative period, o ccurred in 38% of patients in Group 1 and in 52% in Group 2 (P = 0.048 ). Emesis occurred in 34% of patients in Group 1 and in 15% in Group 2 (P = 0.003). Nausea scores were significantly lower for patients in G roup 2 at 2 h (P = 0.023) and at 24 h (P = 0.001). In the ondansetron plus dexamethasone group, 9 out of 10 patients who received propofol f or induction of anesthesia had no emesis. The only failure occurred in a patient who had a single emetic episode during the 24th postoperati ve hour. The combination of ondansetron and dexamethasone was more eff ective than ondansetron and saline in the prevention of postoperative nausea and vomiting for women having major gynecologic surgery.