COMPARISON OF ONDANSETRON AND METOCLOPRAMIDE IN PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING (PONV) AFTER LAPAROSCOPIC VS OPEN CHOLECYSTECTOMY (ADULT PATIENTS)

Abstract

Background: One of the most upsetting side effects of anesthesia is still postoperative nausea and vomiting (PONV), especially during abdominal procedures like laparoscopic and open cholecystectomy. Improved healing results, shorter hospital stays, and patient comfort all depend on effective prevention. Metoclopramide, a dopamine antagonist, and ondansetron, a 5-HT3 receptor antagonist, are often used antiemetics; however, further research is needed to determine how effective they are in various surgical techniques.

Methodology: The efficacy of ondansetron and metoclopramide on postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic and open cholecystectomy will be compared as observational crossectional study. Participants provided information on antiemetic procedures, medication options, medication dosage, time, method of administration and postoperative results of adult patients with open and laparoscopic cholecystectomy. Statistical analysis was done using version 27 of the Statistical Package for the Social Sciences (SPSS). To compare the effects of ondansetron and metoclopramide on PONV incidence, the descriptive statistics (mean, median, mode, and (standard deviation) and inferential tests were applied.

Results: Ondansetron worked better overall than Metoclopramide in avoiding postoperative nausea and vomiting based on the descriptive statistical analysis. The majority of patients did not have PONV as indicated by the mean PONV score of 0.34 (median 0, mean 0, mode 0) Fasting onboard, lower values favoured Ondansetron group. Additionally, overall nausea severity values had higher mean (0.77), median (1.00), and mode (0.00) values, indicating that patients using metoclopramide had more nausea whereas those taking ondansetron had better control. Ondansetron's efficacy was also supported by the low frequency of Mean - 0.49 (median - 0.00 (mode - 0.00), episodes vomiting) In Metoclopramide group had increased rescue antiemetic use (mean 0.51, median 1.00, mode 1.00), indicating that Ondansetron required less additional drugs. Ondansetron superiority was also supported by the low levels of early nausea (mean 0.45), nausea and vomiting (mean 0.27) and PONV at 24 hours (mean 0.32). Lastly patients taking ondansetron had better patient satisfaction (mean 2.16). Overall, these mean, median, and mode values show that ondansetron was better than metoclopramide in prophylactic treatment of PONV and better postoperative results.

Conclusion: The study concludes that ondansetron provides superior prophylaxis against PONV compared with metoclopramide, especially in laparoscopic procedures where emetogenic risk is higher. Adequate intraoperative administration and adherence to guideline- based antiemetic protocols significantly enhance postoperative recovery and patient satisfaction.