Effect of Ondansetron and Dexamethasone to Prevent Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy

Abstract

Background: Postoperative nausea and vomiting (PONV) remains a significant challenge following laparoscopic cholecystectomy, often prolonging hospital stay and impacting patient recovery. Although ondansetron and dexamethasone are widely used for prophylaxis, direct comparisons of their relative efficacy and safety remain limited in this surgical population. Objective: This study aimed to compare the effectiveness and safety profiles of ondansetron and dexamethasone in preventing PONV among patients undergoing elective laparoscopic cholecystectomy, with additional assessment of postoperative complications and hospital stay. Methods: A cross-sectional, randomized comparative study was conducted among 150 adult patients scheduled for elective laparoscopic cholecystectomy. Patients (n = 75 per group) meeting ASA I/II status and aged 20–70 years were randomly assigned to receive either ondansetron or dexamethasone. Exclusion criteria included comorbidities, drug allergies, and conversion to open surgery. Data were collected using standardized clinical assessment tools, with PONV incidence, complications, and hospital stay as primary outcomes. Ethical approval was obtained in accordance with the Declaration of Helsinki. Data were analyzed using SPSS; chi-square and independent t-tests were employed to determine statistical significance (p < 0.05). Results: Ondansetron significantly reduced PONV incidence (17.3% vs. 44.0%, p < 0.001), complications (17.3% vs. 44.0%, p < 0.001), and shortened hospital stay (1.04 ± 0.20 vs. 2.15 ± 0.62 days, p < 0.001) compared to dexamethasone, which was notably associated with hyperglycemia (26.7%). Conclusion: Ondansetron is superior to dexamethasone for PONV prevention in elective laparoscopic cholecystectomy, providing enhanced safety and facilitating earlier discharge. These findings support ondansetron as the preferred antiemetic in perioperative care, improving clinical outcomes and resource utilization.