Comparison of Prophylactic Ondansetron and Pregabalin for Postoperative Nausea and Vomiting: A Randomized Controlled Study

Resumo

Introduction:

Pregabalin is an antiepileptic drug with antiemetic properties. We evaluated prophylactic oral pregabalin as compared with ondansetron for postoperative nausea and vomiting (PONV) in patients undergoing mastoid surgery in a randomized double-blind study.

Material and Methods:

Two hundrd patients of ASA physical status I and II, scheduled to undergo mastoid surgery, were randomly assigned into two groups to receive 150 mg pregabalin or 8 mg ondansetron one hour before surgery. Standard anaesthesia technique was used in all patients. Episodes of PONV were recorded during the first 24 h for two time periods: 0–2 and 2–24 h. Data regarding adverse effects, such as dizziness, headache and drowsiness, were also collected.

Categorical variables were expressed as frequency (%) and chi-square test was applied to test the significance of association between groups and variables. Continuous variables were expressed as Mean with 95% confidence intervals. T-test was performed to compare the mean of variables between two groups. Kaplan-Meier survival analysis was performed for comparing mean or median time of events. Log-rank test was used to test the median survival time. Kolmogorov-Smirnov test was used for testing the equality of the distribution function of sedative score at each time point.

Results:

Pregabalin prophylaxis in patients undergoing mastoid surgery delays the onset and decreases the episodes of vomiting within 2-hours of surgery as compared to ondansetron 8mg. It also reduces the incidence of nausea in the postoperative period, albeit at the cost of higher incidence of sedation.

Conclusions: Pregabalin effectively suppresses PONV in mastoid surgery.