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ORIGINAL ARTICLE
Year : 2013  |  Volume : 29  |  Issue : 2  |  Page : 205-210

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


1 Department of Pharmacology, Christian Medical College, Ludhiana, Punjab, India
2 Department of Anaesthesiology, Burdwan Medical College, Burdwan, West Bengal, India
3 Department of Otorhinolaryngology, Burdwan Medical College, Burdwan, West Bengal, India
4 Department of Biochemistry, Christian Medical College, Ludhiana, Punjab, India

Correspondence Address:
Sandip Mukhopadhyay
Department of Pharmacology, Health Sciences Block, Christian Medical College, Ludhiana - 141 008, Punjab
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9185.111725

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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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