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Original Article
- Effect of Ondansetron combined with Dexamethasone on Postoperative Nausea & Vomiting and Pain of Patients with Laparoscopic Hysterectomy
- Miok Nam1, Haesang Yoon2
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Journal of Korean Academy of Nursing 2009;39(1):44-52.
DOI: https://doi.org/10.4040/jkan.2009.39.1.44
Published online: February 17, 2009
1Head Nurse, Department of Nursing, Gil Medical Center
2Professor, Department of Nursing, Gachon University of Medicine & Science, Incheon, Korea
1Head Nurse, Department of Nursing, Gil Medical Center
2Professor, Department of Nursing, Gachon University of Medicine & Science, Incheon, Korea
- Address reprint requests to : Yoon, Haesang, Department of Nursing, Gachon University of Medicine & Science, 534-2 Yeonsu-dong, Yeonsu-gu, Incheon 406-812, Korea Tel: 82-32-820-4212 Fax: 82-32-820-4201 E-mail: hsyoon@gachon.ac.kr
• Received: May 7, 2008 • Revised: May 13, 2008 • Accepted: January 14, 2009
Copyright © 2009 Korean Society of Nursing Science
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Abstract
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Purpose:
- The purpose of this study was to compare the effects of ondansetron combined with dexamethasone on Post-Operative Nausea and Vomiting (PONV) and pain with ondansetron alone in patients with laparoscopy assisted vaginal hysterectomy under general anesthesia.
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Methods:
- Data were collected from April 1 through September 30, 2005 using a double blind method. Ondansetron 4 mg and dexamethasone 10 mg were administered to the experimental group (25 patients), and ondansetron 4 mg only to the control group (25 patients). The medications were administered through an intravenous line at the beginning peritoneum suture. PONV by Index of Nausea Vomiting and Retching (INVR), nausea by Visual Analogue Scale (VAS), and pain (VAS) were assessed at postoperative 1 hr, 3 hr, 6 hr, 24 hr, and 48 hr. Data were analyzed using repeated measures ANOVA, and Bonferroni methods.
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Results:
- The experimental group that received ondansetron combined with dexamethasone had less PONV (p=.048), and nausea (p=.012) than control group that received ondansetron alone. However, there was no difference in pain (p=.557) between the patients in the two groups.
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Conclusion:
- We conclude that the administration of ondansetron combined with dexamethasone is more effective than the administration of ondansetron alone to reduce PONV in patients with laparoscopic hysterectomy.
Table 1.Homogeneity Test for General Characteristics (N=50)
Table 2.Homogeneity Test for Physiological Characteristics (N=50)
Table 3.Nausea and Vomiting (N=50)
*p<.05; **p<.01; ****p<.001;
�comparison between post op 24 hr and each time;
��comparison between post op 1 hr and each time;
�comparison between Con G and Exp G. Con G=control group; Exp G=experimental group; INVR=Index of Nausea, Vomiting & Retching; Pre op=preoperative; Post op=postoperative; G * T= Group * Time.
Table 4.Pain (N=50
Table 5.Frequency of Administration of Antiemetics, Analgesics, and Pushing PCA Button for Postoperative 24 hr
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XML DownloadEffect of Ondansetron combined with Dexamethasone on Postoperative Nausea & Vomiting and Pain of Patients with Laparoscopic Hysterectomy
Effect of Ondansetron combined with Dexamethasone on Postoperative Nausea & Vomiting and Pain of Patients with Laparoscopic Hysterectomy
Homogeneity Test for General Characteristics (N=50)
| Variables | Category | Con G (n=25) n (%) | Exp G (n=25) n (%) | 2 | p |
|---|---|---|---|---|---|
| Marital status | Married | 21 (42) | 24 (48) | 2.000 | .349 |
| Unmarried | 4 (8) | 1 (2) | |||
| Religion | None | 12 (24) | 11 (22) | 0.406 | .816 |
| Catholic & protestant | 6 (12) | 8 (16) | |||
| Buddhism | 7 (14) | 6 (12) | |||
| Morning sickness | Yes | 18 (36) | 19 (38) | 0.104 | 1.00 |
| No | 7 (14) | 6 (12) | |||
| Smoking | Yes | 3 (6) | 0 (0) | 3.191 | .235 |
| No | 22 (44) | 25 (50) | |||
| Past history of operations | Yes | 10 (20) | 13 (26) | 0.725 | .571 |
| No | 15 (30) | 12 (24) |
Con G=control group (administration of ondansetron); Exp G=experimental group (administration of ondansetron and dexamethasone).
Homogeneity Test for Physiological Characteristics (N=50)
| Variables | Con G (n=25) Mean±SD | Exp G (n=25) Mean±SD | t | p |
|---|---|---|---|---|
| Age (yr) | 44.0±4.7 | 44.5±4.9 | −0.386 | .701 |
| Body weight (kg) | 58.5±6.1 | 59.6±8.3 | −0.526 | .601 |
| Duration of surgery (min) | 94.2±27.5 | 88.4±22.5 | 0.815 | .419 |
| Duration of anesthesia (min) | 125.6±27.4 | 120.2±23.8 | 0.744 | .461 |
| NPO time (hr) | 14.2±4.2 | 16.0±5.5 | −1.279 | .208 |
| Estimated blood loss (mL) | 400.0±204.1 | 374.0±159.5 | 0.502 | .618 |
| Hb (g/dL) | 12.2±1.4 | 11.8±1.7 | 0.956 | .344 |
| Trait anxiety (score) | 41.9±9.1 | 41.2±9.8 | 0.285 | .777 |
| INVR (score) | 0.0±0.0 | 0.0±0.0 | − | − |
| Nausea (mm) | 0.0±0.0 | 0.0±0.0 | − | − |
| Pain (mm) | 0.0±0.0 | 0.0±0.0 | − | − |
Con G=control group; Exp G=experimental group; NPO=nothing by mouth; Hb=hemoglobin; INVR=Index of Nausea Vomiting and Retching.
Nausea and Vomiting (N=50)
| Variable | Time | Con G (n=25) Mean±SD | Exp G (n=25) Mean±SD | Source | F | p |
|---|---|---|---|---|---|---|
| INVR (score) | Pre op | 0.0±0.0 | 0.0±0.0 | Group | 5.67 | .021 |
| Post op 24 hr | 13.6±8.4 | 9.0±8.5 | Time | 34.7 | <.001 | |
| Post op 48 hr**** � | 7.7±8.0 | 3.3±4.7* � | G * T | 3.14 | .048 | |
| Nausea (mm) | Pre op | 0.0±0.0 | 0.0±0.0 | Group | 10.74 | .002 |
| Post op 1 hr | 1.6±5.7 | 1.2±4.4 | Time | 9.56 | <.001 | |
| Post op 3 hr** �� | 14.0±20.2 | 2.8±6.8* � | G * T | 3.49 | .012 | |
| Post op 6 hr** �� | 13.6±22.2 | 5.2±11.6 | ||||
| Post op 24 hr**** �� | 24.8±25.2 | 13.6±21.2 | ||||
| Post op 48 hr** �� | 16.4±18.2 | 3.2±8.0** � |
*p<.05; **p<.01; ****p<.001;
�comparison between post op 24 hr and each time;
��comparison between post op 1 hr and each time;
�comparison between Con G and Exp G. Con G=control group; Exp G=experimental group; INVR=Index of Nausea, Vomiting & Retching; Pre op=preoperative; Post op=postoperative; G * T= Group * Time.
Pain (N=50
| Variable | Time | Con G (n=25) Mean±SD | Exp G (n=25) Mean±SD | Source | F | p |
|---|---|---|---|---|---|---|
| Pain (mm) | Pre op | 0.0±0.0 | 0.0±0.0 | Group | 0.704 | .406 |
| Post op 1 hr | 54.8±1.48 | 53.2±15.7 | Time | 281.8 | <.001 | |
| Post op 3 hr**** �� | 40.0±10.0 | 41.2±13.9 | G * T | 0.792 | .557 | |
| Post op 6 hr**** �� | 31.2±8.3 | 26.4±6.4 | ||||
| Post op 24 hr**** �� | 20.0±7.1 | 19.2±7.0 | ||||
| Post op 48 hr**** �� | 12.8±9.8 | 10.4±6.1 |
****p<.001; ��comparison between post op 1 hr and each time.
Con G=control group; Exp G=experimental group; Pre op=preoperative; Post op=postoperative; G * T=Group * Time.
Frequency of Administration of Antiemetics, Analgesics, and Pushing PCA Button for Postoperative 24 hr
| Variables | Group | Mean±SD | t | p |
|---|---|---|---|---|
| Antiemetics | Con (n=25) | 0.4±0.6 | 1.82 | .760 |
| Exp (n=25) | 0.1±0.3 | |||
| Analgesics | Con (n=25) | 0.3±0.6 | 0.00 | 1.00 |
| Exp (n=25) | 0.3±0.6 | |||
| Pushing PCA botton | Con (n=25) | 3.2±2.3 | 0.81 | .424 |
| Exp (n=25) | 2.7±2.3 |
PCA=Patient Controlled Anesthesia; Con=control; Exp=experimental.
