The effectiveness of Propofol versus Dexamethasone administration for prevention postoperative nausea and vomiting in patients underwent ENT surgery
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Date
2018-03
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Addis Ababa Universty
Abstract
Background: Postoperative nausea and vomiting is a common postoperative unpleasant and distresefull experience with high incidence among Ear, Nose and Throat surgery primarily occurs with 24 hours can lead to significant morbidity. Several studies have shown that small dose of Propofol has direct ant emetics effect as well as Dexamethasone is effective in prevention of Post operative nausea and vomiting with no significant complications in various types of surgery.
Objectives: The aim of the study is to Compare the effectiveness of Propofol vs Dexamethasone administration for prevention of postoperative nausea and vomiting in patients underwent Ear, Nose and Throat surgery at Tikur Anbessa Specialized and Yketit 12 Hospital.
Methods: Institutional based Prospective cohort study was conducted at Tikur Anbessa Specialized and yketit 12 Hospital from December 20- March 20, 2017/18. This study was conducted on 80 ASA I and II patients aged 18-65 years. Data was analyzed by using computer software SPSS version 20. Independent t-test were used for Comparison of symmetric numerical and mannwhitney for asymmetric data between groups. Categorical data were analyzed with the Chi-Square test and P- Value of less than 0.05 were considered as level of the significancy.
Result: The incidences of PONV in overall 24 hours period were 35% in propofol and 25% in Dexamethasone group. There was statistically significant difference was found in the incidence of PONV and use of antiemetic (5% VS 0%) in Propofol and Dexamethasone at 12–24hours periods (22.5% vs. 0%) respectively. In overall period 27.5% of patients in propofol, 22.5% of patients were felt mild nausea in Dexamethasone group while 12.5% of patients in Propofol and 5% of patients in Dexamethasone were felt moderate nausea.
Conclusion and Recommendation: Dexamethasone administration at end of operation was found effective in prevention of postoperative nausea- vomiting and reduction of rescue ant emetics requirement in patients underwent Ear, Nose and Throat surgery. we recommend to use Dexamethasone as prophylaxis of Postoperative nausea and vomiting in Ear, Nose and Throat surgery
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Keywords
Anesthesia, postoperative nausea and vomiting, propofol , dexamethasone