A Comparative Study Between Ondansetron and Gabapentin for Prevention of Postoperative Nausea and Vomiting Following Max
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ORIGINAL ARTICLE
A Comparative Study Between Ondansetron and Gabapentin for Prevention of Postoperative Nausea and Vomiting Following Maxillofacial Surgery Preksha Dubey1
•
Gopal K. Thapliyal1 • Alok Ranjan2
Received: 26 February 2020 / Accepted: 2 April 2020 Ó The Association of Oral and Maxillofacial Surgeons of India 2020
Abstract Background and Aim Gabapentin is an antiepileptic drug with antiemetic properties. We evaluated prophylactic oral gabapentin as compared with ondansetron for postoperative nausea and vomiting (PONV) in patients undergoing maxillo facial surgery. Settings and Design A double-blind, randomized study in a teaching hospital. Materials and Methods Seventy patients of ASA physical status I and II, scheduled to undergo maxillofacial surgery, were randomly assigned into two groups to receive 300 mg gabapentin or 8 mg ondansetron 1 h before surgery. Standard anaesthesia technique was used in all patients. Students’ t test for difference of means between two groups was used for continuous variables. Chi square or Fisher’s exact test was used for comparing proportion between two groups. Kaplan–Meier survival analysis was performed to compare the time to event observed between ondansetron and gabapentin groups. Log-rank test was performed to detect statistical significance of time to events between two groups. Results There was no significant difference in incidence of PONV between two groups within 2 h postoperatively. No incidence of PONV was observed in gabapentin group within 2–24 h as compared to ondansetron group in which PONV was observed in five cases.
& Preksha Dubey [email protected] 1
Department of Oral and Maxillofacial Surgery, ITS Dental College and Research Centre, Greater Noida 201308, India
2
Department of Social and Preventive Medicine, All India Institute of Medical Sciences, Patna, India
Conclusion Gabapentin effectively suppresses PONV in maxillo facial surgery. Keywords Antiemetic Gabapentin Postoperative Maxillo facial surgery
Introduction Postoperative nausea and vomiting [PONV] is a relatively common complication after general anaesthesia, with a reported incidence of 40–90% [1]. PONV can lead to increased morbidity which can significantly increase overall healthcare costs apart from causing distress to the patients. Some patients rate PONV as worse than postoperative pain [2]. PONV prevention can lead to a substantial reduction in healthcare costs by reducing the duration of the postanaesthesia care unit stay [3]. Furthermore, serious complications, including retinal detachment, aspiration, wound dehiscence, oesophageal rupture, and subcutaneous emphysema, related to PONV can be prevented. The incidence of PONV in some subsets of high-risk patients can be higher even after preventive pharmacotherapy [4]. PONV is also of concern in maxillofacial procedures, specifically those mandating jaw fixation and immobilization. There is often fear of aspiration if patient vomits postoperatively. PONV may predispose these patients to increased pain, bleeding, de
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