الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
The purpose of this study was to assess and compare the efficacy of
prophylaxis with either antiemetic medication (ondanstrone) or use ofpropofol
as induction agent only or propofol in induction and maintenance of anaesthesia
for prevention of PONV in 193 patients, 87 males and 106 females aged
between (18-50 years) weighed between 45-90~g .Patients were classified into
4 main groups: group I received thiopental (4-6mg/kg) as induction agent and
maintained with halothane 1%, group II received propofol (2-3mg/kg) as
induction agent and maintained with halothane I%, group III received propofol
(2-3mg/kg) as induction and maintenance (6-10mg/kg/h), group IV received 4
mg ondansetron at time of induction with thiopental (4-6mglkg) and
maintenance with halothane 1%. All groups received fentanyl 2uglkg before
induction, succinylcholine lmg/kg before intubation,N20 in02(Fi02=0.33),
muscle relaxant was pancuronium 0.03mglkg and all patients was reversed by
neostigmine 0.04-0.08mg/kg and atropine 0.01-. 0.02mglkg. Bach group were
further divided into 2 subgroups according to whether surgery was done
laparoscopically (subgroup L) or open (subgroup 0). All patients were
monitored by continuos BCG, blood pressure by oscillometry, pulse oximetry,
capnometry. Measurements were recorded immediate before induction,
immediate after intubation and every 5-min. intraoperative. Postoperative
analgesia was provided by pethidine in dose of Img/kg given intramuscularly
(i.m) at recovery from anaesthesia as a routine for all patients and non steriodal
anti-inflammatory (NSID) diclofenac sodium(Voltaren) in a dose of 75 mg
given i.m on patient request and those patients were excluded from our study .In
PACU, trained anesthesia personnel provided basic monitoring including BCG
blood pressure and pulse oximetry .A special assessment of nausea! vomiting by
Emesis score at 0-2h, 2-4h, 4-6h, 6-8h, 8-24h postoperative and recovery from
SUMMERY AND CONCLUSION 88
anesthesia was carried out by recovery score every 30min overl20min
postoperative. Any adverse effect of each technique and consumption of any
analgesic or antiemetic medications were recorded for 24h. postoperatively.
In the present study results showed that incidence of nausea and vomiting
was significantly less with propofol as induction agent only (group II) than the
use of thiopentone (group I).
Propofol in induction and maintenance (group III) was effective and
significantly better than the group I (induction with thiopentone and
maintenance with halothane) and group II (propofol as induction agent only) in
reducing ofPONV.
Intravenous ondansetron 4mg (group IV) was significantly better than the
group I (induction with thiopentone and maintenance with halothane), group II
(propofol as induction agent only) and group III (propofol in induction and
maintenance) in reducing ofPONV.
Propofol in induction and maintenance (group III) is associated with
significant high recovery score in short time than other groups.
In all groups the incidence of PONY was high in laparoscopic surgery
than in open surgery.
CONCLUSION
Incidence ofPONV was least in group IV (4mg ondansetron i.v at time of
induction with thiopentone and maintenance with halothane) followed by group
III (propofol in induction and maintenance) followed by group II (propofol as
induction. agent only) then followed by group I (induction with thiopentone and
maintenance with halothane)
Prophylactic administration of 4mg ondansetron i.v at time of induction is
effective in reducing PONY.