Haloperidol Versus Dexmedetomidine As An Adjuvant to Ondansetron in Postoperative Nausea and Vomiting in Laparoscopic holecystectomy

Document Type : Original Article

Authors

Department of Anesthesia, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Abstract

Background: Postoperative nausea and vomiting (PONV) is a frequent complication of laparoscopic cholecystectomy,
adversely affecting case recovery. Multimodal antiemetic strategies, including ondansetron combined with other agents,
are often employed for PONV management. Dexmedetomidine, an α2-adrenergic agonist, and haloperidol, a dopamine
receptor antagonist, are known for their antiemetic properties, though their comparative efficacy remains uncertain.
Patients and Methods: This prospective, randomized, double-blind investigation involved 75 adult cases undergoing
laparoscopic cholecystectomy. Participants have been divided into three groups (25 patients each): Group D received
dexmedetomidine (0.5μg/kg) with ondansetron (4mg), Group H received haloperidol (2mg) with ondansetron (4mg),
and Group O received ondansetron (4mg) alone. The primary outcome was the incidence of postoperative nausea and
vomiting (PONV) within 24 hours. Secondary outcomes included the number of nausea/vomiting episodes, time to rescue
antiemetic, postoperative pethidine consumption, sedation scores, and hemodynamic stability.
Results: Dexmedetomidine combined with ondansetron significantly reduced PONV incidence (40% in Group D) compared to haloperidol (76% in Group H) and ondansetron alone (88%, p-value less than 0.001). Time to rescue
antiemetic was longest in Group D (6 hours, p-value equals 0.007). Group D demonstrated lower postoperative pethidine
consumption and higher sedation scores than the other groups. Hemodynamic stability was maintained across all groups.
Conclusion: Dexmedetomidine combined with ondansetron provides superior PONV prophylaxis and reduces opioid
requirements compared to haloperidol with ondansetron or ondansetron alone in cases undergoing laparoscopic
cholecystectomy.

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