Comparison of Dexmedetomidine and Dexamethasone as an adjuvant to ondansetron for prevention of postoperative nausea vomiting in patients undergoing elective spine surgery- A Randomised Double blind Clinical Trial.

The incidence of Post operative nausea vomiting (PONV) is especially high in high risk patients, one of them being patients undergoing spine surgery. Multimodal therapy with a combination of antiemetics like 5 HT3 antagonists combined with phenothiazines, antihistamines and steroids is the preferred modality for PONV prevention in high risk patients. Recently the effect of dexmedetomidine , an alpha 2 agonist, has been the focus of clinical researches. we aimed to evaluate the efficacy of dexmedetomidine when used as an adjuvant to ondansetron   for PONV and compare it with dexamethasone ondansetron combination. After getting institutional ethical committee clearance, 100 patients of age group 18 to 70 years will be enrolled in the study. After standard induction,intubation and positioning the patient prone, the study group will  receive either  5 ml saline bolus followed by  Inj dexmedetomidine infusion continued throughout the period of surgery or Inj Dexamethasone 0.1 mg/kg as 5 ml bolus follwoed by saline infusion throughout the surgery. The anaesthetist blinded to the study will be recording the hemodynamics (HR, MAP) , total dose of opioid and inhalational agent received intraoperatively. After reversal and extubation, patients will be shifted to recovery and followed up every four hours for 24 hours for the presence of PONV and the total rescue antiemetic received.