Postoperative nausea and vomiting are common seguelae of general anesthesia and a leading cause of delayed discharge or hospital readmission after ambulatory surgical procedures. In absence of a preoperative antiemetic 20-40% of adult patients recovering from general anestheskz may experience postoperative emesis. The highest incidence of postoperative vomiting was reported in women undergoing laparoscopic ovum retrival, the next highest occurred after laparoscopy. Various antiernetic have been evaluated for the management of postoperative nausea and vomiting, non have proved to be uniformly effective and some have undesirable side effects. One hundred and fifty women ASA physical status I and a scheduled for diagnostic laparoscopy were recruited into the study. Patients were randomly assigned to one of five groups (n=30 for each) to receive either 2 ml saline 0.9% (control group 1), 4 mg ondansetrone in 2 ml saline 0.9% (group 2&.3) or 4 mg granisetron in 2 ml saline 0.9% (group 4845) given intravenously immediately before induction of anesthesia At the end of surgery after removal of laparoscope metoclopramide 10 mg was given slowly intravenous (in group 3 and 5). Patients with complete response were significantly increased in group 2 3, 4 , 5 in the 1st 8 hours postoperatively compared to group 1. Also the incidence of vomiting significantly decreased in group (3) and (5) compared to groups (2) and (4) allover the study. We conclude that the addition of metoclopramide (10 mg) at the end of surgery to patient receiving ondosetron 4 mg or granisetron 4 mg immediately before induction of anesthesia, improve their effectiveness in prevention of POIVV without increasing their side effects |
