Journal of Anaesthesiology Clinical Pharmacology (Jan 2013)

Betahistine as an add-on: The magic bullet for postoperative nausea, vomiting and dizziness after middle ear surgery?

  • Sandip Mukhopadhyay,
  • Mausumi Niyogi,
  • Ritam Ray,
  • Basabdatta Samanta Mukhopadhyay,
  • Manotosh Dutta,
  • Monoj Mukherjee

DOI
https://doi.org/10.4103/0970-9185.111725
Journal volume & issue
Vol. 29, no. 2
pp. 205 – 210

Abstract

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Purpose: Patients undergoing middle ear surgery experience variable degrees of postoperative nausea and vomiting (PONV) despite prophylaxis and treatment with ondansetron or other 5HT 3 receptor antagonists. Furthermore vertigo or dizziness are not well controlled perioperatively. Role of betahistine was tested as an add-on to ondansetron in control of PONV and vertigo in middle ear surgery cases. Materials and Methods: We conducted a prospective, randomized, double-blind, placebo controlled study, enrolling one hundred patients undergoing middle ear surgery under local anesthesia into two groups consisting of fifty (n = 50) patients each. Group A patients were given betahistine 16 mg plus ondansetron 8 mg and placebo plus ondansetron 8 mg were given to group B or placebo group, orally 3 hours before starting operation. The incidence of nausea, vomiting, and dizziness was noted during the intraoperative and postoperative 24 hours period. Chi-square test, unpaired ′t′ test, and Fisher′s exact tests were performed for statistical analysis using SPSS version 16 and Open Epi version 2.3.1 softwares. Results: Complete response was obtained in 90% patients in the betahistine group as compared to 66% in the placebo group. Vomiting in the intraoperative and postoperative period was noted in 4% and 8% cases, respectively, in the betahistine group as compared to 18% and 26%, respectively, in the placebo group. Overall, vertigo was 10% versus 32% in betahistine group and placebo group, respectively. Conclusion: Betahistine as an add-on to ondansetron can significantly attenuate PONV and perioperative vertigo, following middle ear surgeries.

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