Comparison of Ondansetron and Dexamethasone for Prophylaxis of Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Surgeries: A Meta-Analysis of Randomized Controlled Trials

Table 1

Characteristics of individual studies.

Study	Participants	Intervention	Duration of surgery	Intraabdominal pressure	Control	Rescue antiemetic	Complications	Outcome	Source of bias
Alghanem et al. 2010 [5]	ASA 1 and ASA 2 patients aged 18–70 years scheduled for elective laparoscopic cholecystectomy	patients received 8 mg dexamethasone after induction	44.5 18.1 min in dexamethasone group versus 41.2 13.4 in ondansetron group	10 to 16 mmHg	patients received 4 mg ondansetron after induction	Metoclopramide 10 mg rescue dose, in patients with intractable nausea or lasting for at least 15 min, or at patients request anytime, or with vomiting	No significant complications	Episodes of PONV, nausea and vomiting at; 0 to 4 h and 4 to 24 h intervals
D’souza et al. 2011 [6]	Women aged 20–60 years with ASA grade I/II scheduled for gynecologic laparoscopic surgery	patients received 8 mg dexamethasone before induction	Actual value not reported, no difference in surgical time	10 to 14 mmHg	patients received 4 mg ondansetron after induction	Nausea/vomiting assessed with 4-point scale, retching considered as vomiting, rescue dose 10 mg metoclopramide intravenous	Not reported	Episodes of nausea and vomiting at 0–3 hours,; 3–6 hours, 6–12 hours, and 12–24 hours	Use of nitrous oxide, no mention about intraoperative opioid use
Erhan et al. 2008 [7]	80 ASA I or ASA II patients (61 women and 19 men), aged 21–75 years; scheduled for laparoscopic cholecystectomy	patients received 8 mg dexamethasone 15 minutes before induction	72.0 43.6 min in dexa group versus 69.3 16.9 min ondansetron	12 mmHg	patients received 4 mg ondansetron before induction	PONV recorded by nursing staff, both nausea and vomiting assessed, rescue antiemetic 10 mg metoclopramide intravenous	No significant side-effects	Incidence of nausea and vomiting was recorded; during three assessment periods, 0–6 h, 6–12 h, and 12–24
Gautam et al. 2008 [8]	150 ASA I-II patients, aged between 23 and 65 years, undergoing; elective laparoscopic; cholecystectomy	patients received dexamethasone 8 mg before induction of anaesthesia	79.77 19 min in dexa group versus 77.69 19.0	Below 15 mmHg	patients received 4 mg ondansetron before induction	PONV assessed by 3-point scale, 10 mg metoclopramide intravenous given when if 2 score points were reached or on patients demand	No side-effects reported	Incidence of nausea and vomiting till 24 h after surgery
Mendes et al. 2009 [9]	77 patients; aged 20 to 56 years, ASA II, BMI ≥ 35 kg⋅m^−2; undergoing videolaparoscopic gastroplasty	patients received 0.1 mg⋅kg^−1 of dexamethasone corrected for; body weight up to a maximum of 10 mg	122.5 38.73 min in dexa group versus 153 45.86	Not mentioned	patients received 0.1 mg⋅kg^−1 of ondansetron; up to a maximum of 8 mg	Blinded anesthesiologist, administered 50 mg in presence of nausea or vomiting	No side effects reported	Incidence of nausea vomiting up to 24 h after surgery	Use of intraoperative morphine
Gupta et al. 2006 [10]	100 adult patients undergoing laparoscopic cholecystectomy	patients received dexamethasone 5 mg 90 minutes before induction of anaesthesia	20–60 (48)  min dexa group versus 20–55 (46) min in ondansetron group	12 mmHg	patients received ondansetron 4 mg 90 minutes before induction of anaesthesia	Ondansetron 4 mg intravenously irrespective of the group if patients develop nausea or vomiting, administered by house staff	No postoperative complication reported	Incidence of nausea vomiting up to 48 h after surgery
Yuksek et al. 2003 [11]	ASA PS I or II patients, aged; 19–62 years and undergoing; elective gynaecological; laparoscopy	patients received dexamethasone 8 mg	50.3 (14–98) min in dexa group versus 62.1 (23–90) min in ondansetron group	12–18 min	patients received ondansetron 4 mg	Nausea vomiting assessed by 3-point ordinal scale, rescue 10 mg metoclopramide intravenous by blinded investigator	No complication was reported	Incidence of PONV; immediately after surgery and at 15 min; intervals for 3 h, every 30 min for 3 h,; and then; every 3 h for 18 h