Evaluating the Effectiveness of Ketamine in reducing Postoperative Nausea and Vomiting in Adults after General Anaesthesia: A Prospective Randomized Controlled Trial

Background: Postoperative Nausea and Vomiting (PONV) is defined as any nausea, retching or vomiting occurring during the first 24-48 hours after surgery with a reported incidence of 30% in all post-surgical patients and up to 80% in high risk groups especially in laparoscopic surgeries under general anaesthesia. Many drugs have been tried and tested for abolishing PONV. We evaluated the efficacy of low dose ketamine in decreasing the incidence and severity of PONV following elective laparoscopic surgeries under general anaesthesia. Method: 40 patients belonging to American Society of Anaesthesiologists Physical status I who were scheduled for elective laparoscopic surgeries under general anaesthesia were recruited and randomized into two groups Group A and Group B. Standard protocol for general anaesthesia were followed for all patients. Patients in Group A received Intravenous ketamine of 0.2mg/kg and Patients in Group B received the saline control half an hour before extubation. The incidence and severity of PONV, number of rescue drug administration, and side effects were recorded for first 24 postoperative hours in different time periods. Results: Demographic profile were comparable among the groups. The incidence and severity of postoperative nausea were significantly higher in Group B when compared to Group A for the first 6 postoperative hours (p< 0.05) and thereafter, it was comparable between the groups. The incidence of postoperative vomiting was significantly higher in Group B when compared to Group A for the first 2 postoperative hours (p< 0.04), and then it was comparable between the groups. The number of rescue medications were significantly higher in Group B when compared with Group A. No complications were noted. Conclusion: Low dose intravenous ketamine (0.2 mg/kg) administered as a single bolus reduced the incidence and severity of postoperative nausea and vomiting in adults undergoing laparoscopic surgeries under general anaesthesia without any complications.