Dexamethasone and Ondansetron Versus Placebo for Postoperative Nausea and Vomiting
Dexamethasone and Ondansetron Versus Placebo for Postoperative Nausea and Vomiting
The investigators want to test if it is indicated to associate dexamethasone and ondansetron
 in obese patients having bariatric surgery under total intra-venous closed-loop anesthesia.
Obese patients having bariatric surgery have frequently postoperative nausea and vomiting
 (PONV). We want to test if it is indicated to associate dexamethasone and ondansetron in
 obese patients having bariatric surgery under total intra-venous closed-loop anesthesia.

 Two groups to be studied: one will receive 4 mg dexamethasone at the end of the anesthetic
 induction and 4 mg ondansetron at the end of the surgical procedure, one will receive normal
 saline.

 One hundred twenty consecutive patients meeting the inclusion and exclusion criteria and who
 give written informed consent to participate in the study will be randomly assigned to one of
 two experimental groups using a 1:1 ratio.

 Patients will be continuously monitored in the post anesthesia care unit (PACU) and the
 medical floor for a total of 24 hours post operatively. Episodes of nausea, vomiting and
 administration of rescue therapy for either nausea or vomiting will be recorded and time
 stamped. In addition, severity of nausea will be evaluated by the patient using a standard
 verbal response scale (VRS) ranging from 0-10, 0 being no nausea and 10 being severe nausea.
 Rescue therapy for PONV episodes will consist of 4 mg ondansetron followed by 0.625 mg
 droperidol if necessary.
Inclusion Criteria:

 -  Adult patients aged 18-75 years

 -  Scheduled for bariatric surgery under total intra-venous closed-loop anesthesia

 -  Apfel score equal or greater than 2

 -  Consenting to participate in the study

 Exclusion Criteria:

 -  Pregnant, breast feeding women

 -  Allergy

 -  Contraindication to dexamethasone

 -  Contraindication to ondansetron

 -  Contraindication to propofol, remifentanil, morphine, ketoprofen

 -  Limit to the use of bispectral index