perbandingan efektivitas premedikasi oral ondansetron 4 mg dan dimenhidrinat 50 mg untuk mengurangi mual dan muntah pasca tindakan metode operasi wanita (mow)

• Main Authors: , dr. Adam Kurnia Wandana, , DR. Med. Dr. Untung Widodo, SpAn, KIC.
• Format: Theses and Dissertations NonPeerReviewed
• Published: [Yogyakarta] : Universitas Gadjah Mada 2013
• Subjects: ETD
• Online Access: https://repository.ugm.ac.id/125874/; http://etd.ugm.ac.id/index.php?mod=penelitian_detail&sub=PenelitianDetail&act=view&typ=html&buku_id=66055
• Institution: Universitas Gadjah Mada

Tubal ligation is a gynaecological surgery performed often which includes as an outpatient surgery. The anesthesia technique that can be used in this procedure is the total intravenous anesthesia (TIVA) using diazepam and ketamine. Post-operative nausea and vomiting (PONV) is a complication that occurs often in tubal ligation which delays patient discharge, causes discomfort and increases the risk of aspiration. Ondansetron and dimenhydrinate could be used as antiemetic prophylaxis. This study compares the efficacy of oral premedication dimenhydrinate against ondansetron in reducing PONV after tubal ligation procedure. This is a double blinded randomized clinical trial of 110 patients with physical status of ASA I and II with the TIVA technique using diazepam and ketamine. The patients were randomly assigned to 2 groups. Group D received dimenhydrinate 50 mg per oral and Group O received Ondansetron 4 mg per oral. The incidence of postoperative nausea and vomiting was statistically analysed using the Chi square test, whereby p<0.05 showed statistical significance. Demographic data such as age, body weight, blood pressure and duration of operation were tested using the independent t test. The incidence of PONV in the dimenhydrinate 50 mg per oral group were 15 patients (27.3%) lower than the ondansetron 4 mg per oral with 28 patients (50.9%) and this difference is statistically significant (p=0.011). In the dimenhydrinate group, 40 patients (72.7%) were free of PONV, 9 patients (16.4%) experienced nausea only, and 6 patients (10.9%) experienced vomiting/retching, while in the ondansetron group, 27 patients (49.1%) were free of PONV, 18 patients (32.7%) experienced nausea only and 10 patients (18.2%) experienced vomiting/retching and this difference between the two groups of study is statistically significant (p=0.038). Oral premedication of 50mg dimenhydrinate is more efficacious than ondansetron 4mg in reducing the incidence of PONV in tubectomy operations using the TIVA anesthesia technique using ketamine 1mg/kgBB and diazepam 0.1 mg/kgBB.