Journal of Isfahan Medical School

Journal of Isfahan Medical School

Evaluation and Comparison of the Effects of Propofol, Dexamethasone, and Ondonestrone in the Prevention of Complications during and after Cataract Surgery

Document Type : Original Article (s)

Authors
Khosrow Naghibi 1
Mehrnoosh Dodangeh 2
Seyed Taghi Hashemi 3
Darioush Moradi-Farsani 3
1 Associate Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Assistant Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
10.22122/jims.v36i475.9813
Abstract
Background: One of the complications after cataract surgery is pruritus. In this study for the first time, the effects of intravenous injection of ondansetron, propofol, and dexamethasone on reducing the incidence of pruritus after cataract surgery were compared with the control group.Methods: In this clinical trial study, patients were randomly divided into four groups of dexamethasone, ondansetron, propofol, and normal saline for intravenous infusion. After entering the recovery for up to 6 hours, the patient was asked about itching, nausea, and vomiting. Information was compared between the four groups.Findings: The level of pruritus around the eyes during 0 to 1 hour after the surgery was significantly lower in the ondansetron and dexamethasone groups than others (P < 0.050). There was no significant difference between the groups regarding the level of pruritus around the eyes during 1 to 2 and 2 to 6 hours after the surgery (P < 0.050 for all).Conclusion: Propofol plays a major role in reducing postoperative nausea and vomiting. Ondansetron is effective in reducing nausea and vomiting and itching after the surgery. Dexamethasone is also effective in reducing pruritus around the eyes after the surgery. It is recommended to do more researches with more samples in addition to eliminating the limitations.
Keywords
Cataract
Dexamethasone
Ondansetron
Propofol
Complications
  1. Oliva MS, Schottman T, Gulati M. Turning the tide of corneal blindness. Indian J Ophthalmol 2012; 60(5): 423-7.
  2. Thylefors B. The World Health Organization's programme for the prevention of blindness. Int Ophthalmol 1990; 14(3): 211-9.
  3. Stevens GA, White RA, Flaxman SR, Price H, Jonas JB, Keeffe J, et al. Global prevalence of vision impairment and blindness: Magnitude and temporal trends, 1990-2010. Ophthalmology 2013; 120(12): 2377-84.
  4. Porela-Tiihonen S, Kaarniranta K, Kokki M, Purhonen S, Kokki H. A prospective study on postoperative pain after cataract surgery. Clin Ophthalmol 2013; 7: 1429-35.
  5. Raczynska D, Glasner L, Serkies-Minuth E, Wujtewicz MA, Mitrosz K. Eye surgery in the elderly. Clin Interv Aging 2016; 11: 407-14.
  6. Maltepe F, Kocaayan E, Ugurlu BS, Akdeniz B, Guneri S. Comparison of remifentanil and fentanyl in anaesthesia for elective cardioversion. Anaesth Intensive Care 2006; 34(3): 353-7.
  7. Kumar K, Singh SI. Neuraxial opioid-induced pruritus: An update. J Anaesthesiol Clin Pharmacol 2013; 29(3): 303-7.
  8. Bonnet MP, Marret E, Josserand J, Mercier FJ. Effect of prophylactic 5-HT3 receptor antagonists on pruritus induced by neuraxial opioids: A quantitative systematic review. Br J Anaesth 2008; 101(3): 311-9.
  9. Szarvas S, Harmon D, Murphy D. Neuraxial opioid-induced pruritus: A review. J Clin Anesth 2003; 15(3): 234-9.
  10. Sarvela PJ, Halonen PM, Soikkeli AI, Kainu JP, Korttila KT. Ondansetron and tropisetron do not prevent intraspinal morphine- and fentanyl-induced pruritus in elective cesarean delivery. Acta Anaesthesiol Scand 2006; 50(2): 239-44.
  11. Szarvas S, Chellapuri RS, Harmon DC, Owens J, Murphy D, Shorten GD. A comparison of dexamethasone, ondansetron, and dexamethasone plus ondansetron as prophylactic antiemetic and antipruritic therapy in patients receiving intrathecal morphine for major orthopedic surgery. Anesth Analg 2003; 97(1): 259-63.
  12. Banihashem N, Hasannasab B, Alereza H. Does dexamethasone prevent subarachnoid meperidin-induced nausea, vomiting and pruritus after cesarean delivery? Saudi J Anaesth 2013; 7(2): 138-41.
  13. Koju RB, Gurung BS, Dongol Y. Prophylactic administration of ondansetron in prevention of intrathecal morphine-induced pruritus and post-operative nausea and vomiting in patients undergoing caesarean section. BMC Anesthesiol 2015; 15: 18.
  14. Wang JJ, Ho ST, Uen YH, Lin MT, Chen KT, Huang JC, et al. Small-dose dexamethasone reduces nausea and vomiting after laparoscopic cholecystectomy: a comparison of tropisetron with saline. Anesth Analg 2002; 95(1): 229-32.
  15. McKenzie R, Riley TJ, Tantisira B, Hamilton DL. Effect of propofol for induction and ondansetron with or without dexamethasone for the prevention of nausea and vomiting after major gynecologic surgery. J Clin Anesth 1997; 9(1): 15-20.
  16. Zhang D, Shen Z, You J, Zhu X, Tang QF. Effect of ondansetron in preventing postoperative nausea and vomiting under different conditions of general anesthesia: A preliminary, randomized, controlled study. Ups J Med Sci 2013; 118(2): 87-90.
  17. Rosillo-Meneses LA, Carrillo-Torres O, Gonzalez-Navarro P, Garcia-Garcia JA. Comparison of the antiemetic efficacy of propofol versus ondansetron in nasal surgery. Randomised clinical trial. Rev Med Hosp Gen (Mex) 2018; 81(2): 72-8.
  18. Owczuk R, Wenski W, Polak-Krzeminska A, Twardowski P, Arszulowicz R, Dylczyk-Sommer A, et al. Ondansetron given intravenously attenuates arterial blood pressure drop due to spinal anesthesia: a double-blind, placebo-controlled study. Reg Anesth Pain Med 2008; 33(4): 332-9.
  19. Dorantes-Mendez G, Aletti F, Toschi N, Guerrisi M, Coniglione F, Dauri M, et al. Effects of propofol anesthesia induction on the relationship between arterial blood pressure and heart rate. 2012 p. 2835-8.
  20. Frolich MA, Arabshahi A, Katholi C, Prasain J, Barnes S. Hemodynamic characteristics of midazolam, propofol, and dexmedetomidine in healthy volunteers. J Clin Anesth 2011; 23(3): 218-23.
  21. Billard V, Moulla F, Bourgain JL, Megnigbeto A, Stanski DR. Hemodynamic response to induction and intubation. Propofol/fentanyl interaction. Anesthesiology 1994; 81(6): 1384-93.
  22. Nandate K, Vuylsteke A, Ratsep I, Messahel S, Oduro-Dominah A, Menon DK, et al. Effects of isoflurane, sevoflurane and propofol anaesthesia on jugular venous oxygen saturation in patients undergoing coronary artery bypass surgery. Br J Anaesth 2000; 84(5): 631-3.
  23. Mohaghegh T, Yazdi B, Norouzi A, Fateh S, Modir H, Mohammadbeigi A. Effect of intravenous anesthesia with propofol versus isoflurane inhalation anesthesia in postoperative pain of inguinal herniotomy: A randomized clinical trial. Med Gas Res 2017; 7(2): 86-92.
  24. Kalani N, Zabetian H, Sanie MS, Deylami M, Radmehr M, Sahraei R, et al. The effect of ondansetron and dexamethasone on nausea and vomiting under spinal anesthesia. World J Plast Surg 2017; 6(1): 88-93.
Journal of Isfahan Medical School
Volume 36, Issue 475 - Serial Number 475
March and April 2018
Pages 372-378

  • Receive Date 15 March 2018
  • Accept Date 06 April 2022