Evaluation of oral olanzapine versus oral ondansetron in prevention of postoperative nausea and vomiting in patients undergoing laparoscopic surgeries under general anesthesia: A comparative study

Abstract

Introduction: Nausea and vomiting in the postoperative period occur in 20% to 30% of patients, and together nausea and vomiting are second most common and distressing to patients[1]. The general incidence of vomiting is about 30%, the incidence of nausea is about 50%, and in a subset of high-risk patients, the postoperative nausea and vomiting PONV rate can be high as 80% during the 24hr after emergence[2]. However, the incidence rate of PONV after laparoscopic cholecystectomy (LC) is higher than that after other types of surgery. Materials and methods: Data was randomly collected from 120 ASA I and II patients scheduled for surgery under general anesthesia between 18 to 50 yrs. It was a prospective randomized double blinded study. After obtaining informed written consent from parents, the study population was randomly assigned to two groups using a random sequence (Random Sequence Generator, available at www.random.on). Group A: Patients received Tablet Ondansetron 16mg (2 tablets of ondansetron 8mg) 1 hour before surgery with sips of water. Group B: Patient received Tablet Olanzapine 5mg (2 tablets of Olanzapine 2.5mg) 4 hours before surgery with sips of water. Group A received placebo 4hrs before surgery and Group B received placebo 1hour before surgery. Monitoring includes electrocardiography (ECG), oxygen saturation (SpO2), non-invasive blood pressure (NIBP), end tidal carbon dioxide (EtCO2), respiratory rate (RR), train of four (TOF). Results: Mean age of subjects in group A was 38.7 + 9.8 years and in group B was 35.8 + 9.4 years. There was no significant difference in age distribution between two groups. In Group A 55% were females and 45% were males and in group B 50% of them were female and male respectively. There was no significant difference in gender distribution between two groups with p=0.583. In Group A 56.7% had ASA I and 43.3% had ASA II and in group B 50% of them had ASA I and II respectively to significant difference between two groups with p=0.464. Conclusion: To conclude, our study demonstrates that premedication with oral olanzapine 5mg provides reduction in the overall incidence of post-operative nausea and vomiting (PONV) which is comparable to ondansetron in patients undergoing general anaesthesia. It also reduced analgesic requirement and causes arousable sedation postoperatively.