Comparative Study of the Preemptive Dexmedetomidine With Ondansetron Effect in Reducing the Post-Operative Nausea and Vomiting After Elective Middle Ear Surgery Under General Anesthesia Publisher



Safavi SMR ; Honarmand A ; Nazemoroaia B ; Maleki N
Source: Journal of Isfahan Medical School Published:2025

Abstract

Background: Regarding the high prevalence of postoperative nausea and vomiting and its negative impact on surgical outcomes, this study compared the effect of preemptive single dose dexmedetomidine with ondansetron in reducing the post-operative nausea and vomiting after elective middle ear surgery under general anesthesia. Methods: In this double-blind clinical trial, 162 patients undergoing elective middle ear surgery under general anesthesia were randomly divided into three groups of 54 each: ondansetron (O), dexmedetomidine (D), and control (C). 15 to 20 minutes before surgical incision, Group O received 0.1 mg/kg of ondansetron, group D received 1 μg/kg/min of dexmedetomidine, and group C received 10 cc of normal saline. After that, the patients were followed up in recovery and up to 24 hours after the operation in terms of nausea and vomiting and other study variables. Findings: The severity of nausea after operation based on VAS (visual analog scale) in groups O, D and C was 2.2 ± 0.7, 3.9 ± 0.7, 5.15 ± 1.3 respectively, with significant differences among groups (P = 0.04). Within 24 hours post-surgery, vomiting occurred in 8 (14.8%), 25 (46.3%), and 48 (88.8%) patients in groups O, D, and C, respectively, demonstrating significant intergroup differences (P = 0.003). Conclusion: Ondansetron proved more effective than dexmedetomidine in reducing the incidence of postoperative nausea and vomiting. Considering its superior efficacy and minimal impact on hemodynamic stability, ondansetron is recommended for postoperative nausea and vomiting prophylaxis in middle ear surgeries. © 2025 Elsevier B.V., All rights reserved.