Dexamethasone and Ondansetron Combined Decreases Postoperative Nausea and Vomiting in Orthognathic Surgery Compared With Dexamethasone Alone: A Prospective Randomized Controlled Trial
Abstract
Objective
This study aimed to compare the efficacy of dexamethasone alone and dexamethasone-ondansetron combined for preventing postoperative nausea and vomiting (PONV) in patients undergoing orthognathic surgery.
Methods
Patients scheduled to undergo mandibular orthognathic surgery who were 18 to 50 years of age and American Society of Anesthesiologists physical status I or II were enrolled. Dexamethasone 6.6 mg was administered after intubation, followed by either ondansetron 4 mg (group DO) or saline placebo (group D) 15 minutes before the end of surgery. Nausea severity was assessed at 3 times postoperatively (immediately after the end of anesthesia, 2 hours later, and 24 hours later) using a 11-point numeric rating scale (NRS). If a patient complained of postoperative nausea or vomited, the NRS score was reevaluated. If the NRS score was 3 or higher, intravenous metoclopramide 10 mg was administered for PONV rescue. Assessed data included nausea NRS scores, vomiting, metoclopramide use, and other patient demographics.
Results
Mean nausea NRS scores at 2 hours were significantly lower in group DO vs group D (0.3 vs 2.1; P = .003), but differences in vomiting rates were not significant (P > .05). PONV rescue rates with metoclopramide were lower overall and at 2 hours later in group DO (P < .001).
Conclusion
Dexamethasone combined with ondansetron was more effective in preventing early postoperative nausea and reducing need for PONV rescue than dexamethasone alone for…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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