Anästhesie und klinische Forschung
Offener Zugang

Abstrakt

Comparative Study between Ondansetron, Isopropyl Alcohol Inhalation and Super Hydration in Treatment of Postoperative Emesis after Laparoscopic Appendectomy

Mohamed Gaber Ibrahium Mostafa Allam

Introduction: PONV affect 35% of the postoperative patients especially those who had general anesthesia. And affect 65% of patients who had laparoscopic abdominal surgery. Ondansetron is one of most effective drugs used to control those complications. Yet its complication limits its use in large scales. Isopropyl alcohol inhalation and super hydration now compete ondansetron in its action and they are safer.

Aim of the work: To compare and evaluate the antiemetic effect and the safety of ondansetron, inhalational isopropyl alcohol and super hydration on adult patients after laparoscopic appendectomy.

Patients and methods: This prospective double-blind study done on 240 patients admitted to surgical I.C.U after laparoscopic appendectomy. Those who had preoperative Koivuranta vomiting score of more than 3 enrolled in our study. Every group contains 80 patients. Patients of group A received ondansetron 4 mg intravenous immediately once reached to I.C.U and another same dose after 6 hours while patients of group B received isopropyl alcohol 70% inhalation every 15 min for 4 times then repeated after 6 hours. The last group C received intravenous normal saline at rate of 20 ml/kg over 30 minute and repeated by the same dose after 6 hours. The duration of the study was 24 hours post-operatively. As PONV is self-limited within 24 hours. Results: no significant difference was found between the three drugs as regard control of all parameters (0,1,2,3 and 4) of severity of PONV between the studied groups in the studied durations. As regards number of patients had no experience of N&V, number of patients had mild, moderate, frequent and/or severe continuous N&V. No significant difference in the number of patients discharged from ICU, accepted all kind of oral fluid, semisolid diet and soft diet and no significant difference in the number of patients had vomiting after oral fluid, semisolid diet and soft diet, No significant difference in patient's and nurse's satisfaction. While there was significant less postoperative complication in patients of group B and C compared to patients of group A.

Conclusion: Inhalational isopropyl alcohol and super hydration had the same antiemetic effect as ondansetron with significant less complication if used after laparoscopic appendectomy.