CTRI

The anaesthetist who is involved in randomization of patients will also be involved in induction and intubation of both the groups of patients and further management and observation of the incidence of post operative nausea and vomiting will be by another anaesthesiologist. Thus the observer and the patient will be blinded for the study drug. Inj dexamethasone 4mg, Inj Midazolam 0.01mg/kg body weight and Inj. Fentanyl 1microgram/kg body weight will be given as a part of premedications. All the patients after preoxygenation with 100% oxygen for 3 minutes, will be induced with propofol 2mg/kg body weight till the loss of eye lash reflexes. 0.1 mg/kg body weight of vecuronium will be administered for all patients. All patients will be mask ventilated with 100% oxygen and 1% isoflurane and the mode of ventilation changes depending on the group they belong to for 5 minutes and intubated with appropriate ET tubes. Patients will be maintained on O2&N2O and Isoflurane. Intaroperative heart rate (HR) and blood pressure (BP) will be monitored and any haemodynamic instability will be managed as per the institutional protocol. Patients will be administered with Paracetamol 1gm IV and 75mg diclofenac IV 20 minutes before extubation. Inj. Ramosetron 0.3 mg IV will be administered in both the groups 20 minutes before the end of surgery. At the end of surgery, patients will be reversed with Neostigmine 0.05mg/kg and Glycopyrrolate 0.01mg/kg body weight. Time of recovery will be noted from the time of administering reversal drugs and patients satisfying the extubation criteria are extubated. All patients will be shifted to post anaesthesia care unit (PACU) and monitored. Incidence of post operative nausea and vomiting will be noted at 0 hour and every 2nd hourly upto 6 hours and every 6th hourly upto 24 hours in both groups. Incidence of post-operative vomiting will be noted and treated with Inj.Metoclopramide 10mg IV (as a rescue antiemetic) and the number of injections will be noted. Post operative nausea will be assessed with VAS (visual analogue scale). Post op analgesic requirement will be also noted. All patients will be interviewed regarding the occurrence of nausea and vomiting 2nd hourly upto 6 hours and every 6th hourly upto 24 hours in both groups and were asked to rank their nausea using a four-point verbal rating scale (0 = none, 1 = mild, 2 = moderate, 3 = severe). Patient satisfaction at 24 h post-surgery will be quantified using a three-point scale (0 = dissatisfied, 1 = neither satisfied nor dissatisfied, 2 = satisfied).