Comparison of Low-Dose Promethazine and Dexamethasone against Ondansetron Monotherapy Given as Antiemetic Prophylaxis during Myomectomy Under Spinal Anesthesia: A Randomized Clinical Trial. (25th August 2022)

• Record Type: Journal Article
• Authors: Onokpite, Emmanuel; Jasper, Abiodun Oyinpreye; Edomwonyi, Philomina Nosa
• Other Names: Minervini Giuseppe Academic Editor.
• Is Part Of: Anesthesiology research and practice. Volume 2022(2022)
• Publication Date: 2022-08-25
• Subjects: Anesthesiology -- Periodicals; 617.9605
• DOI: 10.1155/2022/2094662
• Languages: English
• ISSNs: 1687-6962

Abstract

Abstract : Background . Postoperative nausea and vomiting (PONV) prophylaxis is still inadequate for a significant proportion of women undergoing myomectomy under spinal anesthesia; and it substantially decreases patient's quality of postoperative recovery. Current protocol and practice favor the use of combination therapy like promethazine/dexamethasone for PONV prophylaxis with minimal side effects and cost advantages in low-resource climes. Methodology . Seventy American Society of Anesthesiologist (ASA) class I or II women aged 21–65 years scheduled for myomectomy were recruited and randomized into group A (promethazine/dexamethasone group) and group B (ondansetron group). Myomectomy was performed on each patient using spinal anesthesia. After induction of spinal anesthesia, patients in group A received intravenous promethazine 12.5 mg and dexamethasone 8 mg while group B received intravenous ondansetron 8 mg. Early (0–3 h) and late (4–24 h) PONV was assessed using the numerical scoring scale. Results . Data analysis was done using SPSS version 20. Postoperatively, there was no significant difference in the incidence of early ansd late PONV (p value >0.05) despite the higher incidents in the ondansetron group. The proportion of patients who required rescue antiemetics was more in the ondansetron group when compared with the promethazine/dexamethasone, with minimal and statistically insignificant side effects in both groups. There was significant patient satisfaction in both groups. Conclusion . The study shows that the combination of low-dose promethazine and dexamethasone is comparable to ondansetron when used as prophylaxis for PONV with cost benefits in low-resource environments.