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

• Main Authors: Sandip Mukhopadhyay (Author), Mausumi Niyogi (Author), Ritam Ray (Author), Basabdatta Samanta Mukhopadhyay (Author), Manotosh Dutta (Author), Monoj Mukherjee (Author)
• Format: Book
• Published: Wolters Kluwer Medknow Publications, 2013-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 0970-9185; 10.4103/0970-9185.111725
• Keywords: Betahistine; middle ear surgery; nausea; ondansetron; postoperative nausea and vomiting; vertigo; vomiting; Anesthesiology; RD78.3-87.3; Pharmacy and materia medica; RS1-441
• Source: Journal of Anaesthesiology Clinical Pharmacology, Vol 29, Iss 2, Pp 205-210 (2013)

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.