Comparison of Dexamethasone versus Ondansetron for Postoperative Nausea and Vomiting in Laparoscopic Cholecystectomy

BACKGROUND: Postoperative nausea and vomiting (PONV) are a prevalent complication after laparoscopic surgeries, with an incidence reaching up to 63% without antiemetic prophylaxis. OBJECTIVES: To evaluate the efficacy of dexamethasone and ondansetron in preventing PONV in patients undergoing elective laparoscopic cholecystectomy (LC). MATERIALS AND METHODS: This prospective, randomized, double-blinded clinical trial. Patients scheduled for elective LC under general anesthesia were randomized to receive either ondansetron (100 μg/kg) or dexamethasone (100 μg/kg). PONV was assessed at various postoperative intervals. Primary outcomes included the incidence and severity of PONV, while secondary outcomes included the need for rescue antiemetics. RESULTS: A total of 52 patients (Group D: 26 and Group O: 26) were included in the study. The incidence of immediate PONV was 3.8% in Group D and 0% in Group O (P = 0.313). No significant difference was observed between groups at 1-2 h and 4 h, and no PONV was reported at 8-, 12-, or 24-h intervals in either group. Vomiting episodes were noted in 15.4% of Group D and 23.1% of Group O patients. Rescue antiemetic use was higher in Group O (34.6%) compared to Group D (19.2%), with no significant difference between the groups (P = 0.211). CONCLUSIONS: Dexamethasone and ondansetron are both effective for PONV prophylaxis in patients undergoing LC, with comparable efficacy, although ondansetron may require slightly more frequent use of rescue antiemetics.