Midazolam versus dexamethasone-ondansetron in preventing postoperative nausea-vomiting in patients undergoing laparoscopic surgeries.

BACKGROUND Midazolam reduces postoperative nausea and vomiting (PONV) when compared to a placebo or when used as an adjuvant to other antiemetics. The present study was designed to compare midazolam with a combination of dexamethasone-ondansetron in preventing PONV. METHODS One hundred and twenty patients undergoing laparoscopic surgeries having 2 or more risk factors for PONV (simplified Apfel score) were randomised into two groups of 60 each. Patients in group D received 8mg dexamethasone and 4 mg ondansetron for PONV prophylaxis while those in group M received 2 mg midazolam towards the end of surgery. The proportion of patients (frequency) who had PONV, postoperative nausea (PON), postoperative vomiting (POV) was noted over 24 hours over the following intervals: 0-2 hours, 2-24 hours and 0-24 hours RESULTS: The frequency of PONV at 24 hours in group D and group M was 30% and 33.3% respectively and was not significantly different (P=0.70). There was no difference the time to achieve post anaesthesia discharge score of ≥9 between the two groups {5 minutes (5, 5) in group D; 5 minutes (1.25, 5) in group M, P=0.48}. Ten patients in group D and 11 in group M required a rescue antiemetic over 24 hours (P=0.81). The frequency of PON, POV and PONV as well as the median PONV score was similar at all time periods. CONCLUSION Midazolam does not result in significantly different frequency of PONV than a combination of dexamethasone-ondansetron.