COMPARISION OF THE EFFICACY OF METOCHLOPROMIDE AND ONDANSATRON FOR THE PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING IN LAPAROSCOPIC CHOLECYSTECTOMY SURGERIES

Abstract

Background: Laparoscopic cholecystectomy is a procedure with frequent and painful postoperative nausea and vomiting (PONV). Prevention of PONV is significant in ensuring that patients feel more comfortable, have fewer postoperative problems, and recover faster. Antiemetic agents such as ondansetron and metoclopramide are more or less universal tools but their relative effectiveness in the prevention of PONV in laparoscopic patients undergoing cholecystectomy is still a significant clinical issue.

Objectives: This study aims to evaluate how effective ondansetron and metoclopramide are in preventing PONV in patients who have had laparoscopic cholecystectomy procedures.

Methodology: This descriptive cross sectional study is conducted. One hundred and sixty patients undergoing elective laparoscopic cholecystectomy under general anesthesia are considered and randomly divided into two equal groups, i.e. Ondansetron group (n = 80) and Metoclopramide group (n = 80). The severity of nausea is measured with the help of a Visual Analogue Scale (VAS, 0-10). Incidences of vomiting and general incidences of nausea in the first 24 hours of surgery are recorded. Independent t-test of continuous variables and chi test of categorical variables are used to analyze data with p = 0.05 as the significance level.

Results: Ondansetron group scores are significantly lower than Metoclopramide group in terms of the severity of nausea scores (1.6 ± 1.2, 1.8 ± 1.4 and 1.2 ± 1.0 at 2, 6 and 24 hours) with p = 0.01. The rate of nausea during the 24 hour period is less in the Ondansetron group (17.5) as compared to the Metoclopramide group (38.8) (p = 0.003). There are lesser vomiting episodes in the Ondansetron group (6.3) than in Metoclopramide group (21.3) (p = 0.006). The general PONV incidence is still lower in the Ondansetron group (14 cases) as compared to that in Metoclopramide group (31 cases) (p = 0.003).

Conclusion: Ondansetron is considerably more effective than metoclopramide at reducing the nausea severity, number of vomiting episodes and total incidence in patients undergoing laparoscopic cholecystectomy surgeries.