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Postoperative Nausea and Vomiting (PONV)Phase 4NCT06886230

Ondansetron vs. Dexamethasone for Postoperative Nausea

A Phase 4 study testing Ondansetron (Zofran) and Dexamethasone in people with Postoperative Nausea and Vomiting (PONV), run by Hafiz Muhammad Hamza at 1 site in Pakistan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This randomized controlled trial aims to evaluate the safety and efficacy of Ondansetron, Dexamethasone, and their combination in managing postoperative nausea and vomiting (PONV) in patients undergoing surgery under anesthesia. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Postoperative Nausea and Vomiting (PONV)
What is being tested?
Ondansetron (Zofran) and Dexamethasone
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
105 participants
Where
1 sitePakistan
Study dates
20 Mar 2025to 11 Jun 2025
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adult patients (≥18 years) scheduled for elective surgery under anesthesia.
  • Patients at moderate to high risk for postoperative nausea and vomiting (PONV), as determined by an Apfel risk score ≥2.
  • Patients able to provide informed consent or have a legally authorized representative provide consent.

Who cannot join

  • Known allergy or hypersensitivity to Ondansetron, Dexamethasone, or any of their components.
  • History of significant adverse reactions to previous PONV prophylaxis with Ondansetron or Dexamethasone.
  • Pre-existing conditions or medications contraindicating the use of Ondansetron or Dexamethasone, e.g. QT prolongation or severe cardiac arrhythmias (e.g., torsades de pointes, congenital long QT syndrome), Uncontrolled hypertension (for Dexamethasone use), Severe hepatic impairment (Child-Pugh C) or end-stage renal disease, Uncontrolled diabetes mellitus (due to Dexamethasone-induced hyperglycemia).
  • Patients with active malignancy undergoing chemotherapy or radiotherapy.
  • Pregnant or lactating women (unless safety in this population is specifically being studied).
  • Chronic opioid users (≥3 months of continuous opioid use), as this may alter PONV risk and response to prophylaxis.

Trial locations and contacts

1 site in 1 country.

Pakistan1 site
  • Federal Government Polyclinic (Postgraduate Medical Institute)

    Islamabad, Capital, 051

Other trials in Pakistan

About this study

Official title: Assessing The Safety and Efficacy of Ondansetron, Dexamethasone, and Their Combined Regimen in Managing Post Operative Nausea and Vomiting: A Randomized Controlled Trial

This randomized controlled trial aims to evaluate the safety and efficacy of Ondansetron, Dexamethasone, and their combination in managing postoperative nausea and vomiting (PONV) in patients undergoing surgery under anesthesia. A total of 100 patients will be randomized into four groups: Placebo, Ondansetron, Dexamethasone, and Ondansetron-Dexamethasone combination. The primary outcome will be the incidence of PONV within 24 hours post-surgery, while secondary outcomes include severity of symptoms, need for rescue medication, adverse effects, and patient satisfaction.

Read the detailed description

Postoperative nausea and vomiting (PONV) is a common and distressing complication following surgery, affecting patient recovery and satisfaction. This study aims to compare the safety and effectiveness of Ondansetron, Dexamethasone, and their combination for PONV prevention.

The study will be conducted as a randomized, controlled trial at Federal Polyclinic Hospital Islamabad over four months. A total of 100 adult patients undergoing elective surgery under anesthesia will be enrolled and randomly allocated into one of four groups (n=25 each):

Placebo group - Receives no prophylactic antiemetic treatment. Ondansetron group - Receives 4 mg IV Ondansetron before surgery. Dexamethasone group - Receives 8 mg IV Dexamethasone before surgery. Ondansetron-Dexamethasone group - Receives 4 mg IV Ondansetron + 8 mg IV Dexamethasone before surgery.

Methodology:

Patients will be assessed at multiple time points (2, 4, 6, 12, and 24 hours postoperatively) for PONV incidence and severity, along with the need for rescue medication. Side effects such as headache, dizziness, hypertension, and hyperglycemia will also be monitored.

Statistical Analysis:

Data will be analyzed using chi-square tests and ANOVA to compare outcomes across treatment groups. A p-value < 0.05 will be considered statistically significant.

This study will help determine the most effective and safest antiemetic regimen, guiding clinical decision-making for better PONV management.

Being tested
Placebo (Normal Saline), Ondansetron (Zofran), Dexamethasone
Keywords
nausea, vomiting, PONV, randomized controlled trial, ondansetron, dexamethasone
Medical subject headings
Postoperative Nausea and Vomiting, Nausea, Vomiting

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Placebo (Normal Saline)Drug

    Also called Saline Injection, Inert Solution

    Patients in this group will receive an intravenous (IV) injection of normal saline before surgery. This serves as a control group to compare the efficacy of active treatment groups in preventing postoperative nausea and vomiting.

  • Ondansetron (Zofran)Drug

    Also called Zofran, Ondem, Emeset

    Patients in this group will receive a single intravenous (IV) dose of Ondansetron 4 mg before surgery. Ondansetron is a selective 5-HT3 receptor antagonist commonly used to prevent nausea and vomiting associated with anesthesia and surgery.

  • DexamethasoneDrug

    Also called Decadron, Dexasone

    Patients in this group will receive a single intravenous (IV) dose of Dexamethasone 8 mg before surgery. Dexamethasone is a corticosteroid with anti-inflammatory properties that has been shown to reduce the incidence of PONV by modulating inflammatory pathways and neuroreceptor activity.

Study groups in NCT06886230
Study groupRoleWhat they receive
Arm 1: Placebo Group (Control)Placebo comparatorPatients in this group will receive a placebo (normal saline) intravenously before surgery. This group serves as a control to compare the efficacy and safety of the active treatment regimens.
Receives: Drug: Placebo (Normal Saline)
Arm 2: Ondansetron GroupActive comparatorPatients in this group will receive a single dose of Ondansetron 4 mg IV before surgery. Ondansetron is a 5-hydroxytryptamine type 3 receptors antagonist commonly used for postoperative nausea and vomiting prevention.
Receives: Drug: Ondansetron (Zofran)
Arm 3: Dexamethasone GroupActive comparatorPatients in this group will receive a single dose of Dexamethasone 8 mg IV before surgery. Dexamethasone is a corticosteroid that has been shown to reduce postoperative nausea and vomiting.
Receives: Drug: Dexamethasone
Arm: 4 Combination Therapy GroupActive comparatorPatients in this group will receive a combination of Ondansetron 4 mg IV and Dexamethasone 8 mg IV before surgery. The combination therapy is expected to have an additive effect in reducing PONV.
Receives: Drug: Ondansetron (Zofran); Drug: Dexamethasone

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Incidence of Postoperative Nausea and Vomiting (PONV)

    Defined as the presence of nausea and/or vomiting at any assessment time point (recovery, 2, 4, 6, 12, and 24 hours postoperatively).

    Comparison of postoperative nausea and vomiting incidence between the Ondansetron-Dexamethasone and Ondansetron groups.

    The need for rescue antiemetic administration as an indicator of postoperative nausea and vomiting severity.

    Measured: 24 hours

Secondary outcomes (10)
  1. Severity of Postoperative Nausea and Vomiting (Postoperative Nausea and Vomiting Impact Scale Score)

    Assessment of the frequency, severity, and impact of nausea and vomiting on daily activities and quality of life.

    Measured using patient-reported responses to the Postoperative Nausea and Vomiting Impact Scale.

    Scoring Range: 0 to 6 Minimum Score (0): No impact of nausea or vomiting Maximum Score (6): Severe impact on daily activities Interpretation: Higher scores indicate a worse outcome, with greater severity and impact of PONV.

    Measured: 24 hours

  2. Postoperative Pain Scores (Visual Analog Scale Score)

    Pain intensity recorded at recovery, 2, 6 and 24 hours postoperatively using the Visual Analog Scale. A 10-point scale ranging from 0 (no pain) to 10 (worst possible pain). Higher scores indicate greater pain severity.

    Comparison of pain levels between the two groups to determine any analgesic effects of dexamethasone.

    Measured: 24 hours

  3. Need for Rescue Medication

    Frequency and timing of rescue antiemetic administration in both groups. Determines the effectiveness of the interventions in controlling postoperative nausea and vomiting.

    Measured: 24 hours

  4. Adverse Effects of Medications

    Frequency of ondansetron-related side effects: headache, dizziness, constipation, diarrhea, fatigue, allergic reactions.

    Frequency of dexamethasone-related side effects: increased appetite, insomnia, mood changes, fluid retention, hypertension, hyperglycemia.

    Measured: 24 hours

  5. Satisfaction with Postoperative Nausea and Vomiting Management

    Patient-reported satisfaction levels with nausea and vomiting management, measured using the satisfaction scale in the questionnaire.

    Each response is scored on a 5-point Likert scale, where:

    1. = Very dissatisfied (minimum score)
    2. = Somewhat dissatisfied
    3. = Neutral
    4. = Somewhat satisfied
    5. = Very satisfied (maximum score) The total score ranges from 5 (minimum satisfaction) to 25 (maximum satisfaction), with higher scores indicating better patient satisfaction.

    Measured: 24 hours

  6. Apfel Score: Risk Assessment for Postoperative Nausea and Vomiting (PONV)

    Apfel Score Components (Each Risk Factor = 1 Point) Female gender → (Yes = 1 point, No = 0 points) History of postoperative nausea and vomiting or motion sickness → (Yes = 1 point, No = 0 points) Non-smoker → (Yes = 1 point, No = 0 points) Planned use of postoperative opioid analgesia → (Yes = 1 point, No = 0 points) Higher Apfel Scores indicate an increased risk of postoperative nausea and vomiting.

    Measured: 24 hours

  7. Heart Rate

    Heart rate (beats per minute) will be continuously monitored and recorded at predefined intraoperative and postoperative time points to assess hemodynamic stability and detect potential bradycardia or tachycardia.

    Measured: 24 hours

  8. Blood Pressure

    Systolic and diastolic blood pressure (measured in mmHg) will be recorded at regular intraoperative and postoperative intervals to monitor hemodynamic stability and detect episodes of hypotension or hypertension.

    Measured: 24 hours

  9. Respiratory Rate

    Respiratory rate (measured in breaths per minute) will be monitored intraoperatively and postoperatively to evaluate respiratory function and detect potential respiratory depression or distress.

    Measured: 24 hours

  10. Oxygen Saturation

    Oxygen saturation levels (SpO₂, measured as a percentage) will be continuously monitored throughout the intraoperative and postoperative periods to assess respiratory function and detect hypoxia.

    Measured: 24 hours

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Mar 2025
  2. Study start20 Mar 2025
  3. Primary completion10 Jun 2025
  4. Study completion11 Jun 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
This study follows a randomized, parallel-group, single blinded placebo-controlled interventional design to assess the efficacy and safety of Ondansetron, Dexamethasone, and their combination in preventing postoperative nausea and vomiting (PONV).
Masking
Single blind
Who is masked
Participant
Enrolment
105 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06886230
Sponsor's protocol ID
FGPC.1/12/2024 E-Committee
Status last verified
Mar 2025
First submitted
6 Mar 2025
Last updated
17 Jun 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: At this stage, no final decision has been made regarding the sharing of individual participant data (IPD). Data sharing will be considered based on future research needs, ethical guidelines, and institutional policies. Any decision to share IPD will be made in compliance with data protection regulations and patient confidentiality standards.

Publications

  • Bhattarai B, Shrestha S, Singh J. Comparison of ondansetron and combination of ondansetron and dexamethasone as a prophylaxis for postoperative nausea and vomiting in adults undergoing elective laparoscopic surgery. J Emerg Trauma Shock. 2011 Apr;4(2):168-72. doi: 10.4103/0974-2700.82200.

    PubMed 21769200
  • Thanuja IL, Parida S, Mishra SK, Badhe AS. Effect of combinations of dexamethasone-ondansetron and dexamethasone-ondansetron-aprepitant versus aprepitant alone for early postoperative nausea and vomiting after day care gynaecological laparoscopy: A randomised clinical trial. Indian J Anaesth. 2021 Jun;65(6):465-470. doi: 10.4103/ija.IJA_119_21. Epub 2021 Jun 22.

    PubMed 34248190
  • Bilgen S, Kizilcik N, Haliloglu M, Yildirim G, Kaspar EC, Koner O. Effect of the Dexamethasone-Ondansetron Combination Versus Dexamethasone-Aprepitant Combination to Prevent Postoperative Nausea and Vomiting. Turk J Anaesthesiol Reanim. 2018 Sep;46(5):373-380. doi: 10.10.5152/TJAR.2018.53179. Epub 2018 Sep 4.

    PubMed 30263861

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Ondansetron (Zofran) and Dexamethasone in people with Postoperative Nausea and Vomiting (PONV), run by Hafiz Muhammad Hamza at 1 site in Pakistan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 17 Jun 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Incidence of Postoperative Nausea and Vomiting (PONV) (time frame: 24 hours). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06886230, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Jun 2025.

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