Comparison between Sub-Anaesthetic Dose of Propofol and Ondansetron as Pretreatment Options in Prevention of Post Operative Nausea and Vomiting in Pregnant Females after Spinal Anaesthesia

Background: PONV is a common long-standing post-operative problem in anesthesia and remains a challenge, especially in obstetrics populations, and occurs more often after caesarean operations under regional anesthesia. Many anti-emetics have been studied for effectively attenuating post operative nausea and vomiting in pregnant females but there is no evident literature comparing the efficacy of sub-anaesthetic doses of propofol with ondansetron as pretreatment options on reducing the incidence and severity of post operative nausea and vomiting, this study was designed to compare efficacy of 0.5mg/kg propofol and 0.1mg/kg ondansetron intravenous pretreatment for PONV prevention in pregnant females. Aims: Aim of this study is to compare the efficacy of sub-anaesthetic dose of propofol with ondansetron in prevention of incidence and severity of post operative nausea and vomiting.  Material and Methods: This prospective randomized double blind study was conducted in a tertiary hospital associated with a medical college, 60 patients undergoing elective caesarean section under spinal anaesthesia were randomly allocated to one of the two groups Group I received 0.5mg/kg of propofol and Group II 0.1mg/kg of Ondansetron, 10 minutes before completion of surgery, patients were assessed for incidence and severity of nausea and vomiting over next twenty four hours. Students t test, chi square test were used as per the requirement and a P value of <0.05 was considered statistically significant. Result: Out of 60 patients 30 were pretreated with propofol and 30 were pretreated with ondansetron 10 minutes before completion of surgery. In our study 8(26.66%) patients from propofol group developed PONV whereas only 2(6.66%) patients from ondansetron group developed PONV. In our study severity of PONV was calculated on a 3 point scale, it was observed to be 0.33 in patients belonging to propofol pretreatment group whereas it was observed to be 0.10 in ondansetron pretreatment group. Conclusion: Both groups were comparable with respect to demographic characteristics, the incidence(26.66% in group I vs. 6.66% in group II) and severity(0.33 in group I vs 0.10 in group II), of PONV was significantly reduced in ondansetron pretreatment group as compared to propofol pretreatment group, (95% confidence interval, P < 0.05).