Alia Saberi1, Seyed Hashem Pourshafie2, Ehsan Kazemnejad-Leili3, Shadman Nemati4, Sara Sutohian5, Sara Sayad-Fathi6. 1. Neuroscience Research Center, Neurology Department, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran. 2. Road Trauma Research Center, Emergency Department, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran. 3. Rhino-sinus, Ear and Skull Base Diseases Research Center, Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran; Neuroscience Research Center, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran. 4. Rhino-sinus, Ear and Skull Base Diseases Research Center, Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran; Neuroscience Research Center, Guilan University of Medical Sciences, Rasht, Iran. Electronic address: drshadmannemati_ent@yahoo.com. 5. Student Research Committee, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. 6. Neuroscience Research Center, Department of Anatomical Sciences, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.
Abstract
BACKGROUND:Vertigo is a common annoying complaint needing emergent treatment. There are various treatment options for this condition with different outcomes and side effects. OBJECTIVES: Assessment and comparison of the effectiveness of Ondansetron and Promethazine in the treatment of acute peripheral vertigo. MATERIALS AND METHODS: This clinical trial was conducted in an academic hospital in the north of Iran in 2017. A total of 170 eligible patients were randomly allocated to groups A: received intramuscular (IM) promethazine; and B: received intravenous (IV) Ondansetron, using quadripartite blocks. The severity of vertigo, nausea, blood pressure, heart rate, side-effects, need for re-administration, and the time to become asymptomatic were assessed before the injections, 30 min after and 2 h after the injections. RESULTS: Excellent improvement in vertigo occurred in both groups (P < 0.001), with a more significant reduction in the promethazine-treated group (P < 0.001). Nausea was reduced more significantly in the ondansetron-treated group (P < 0.05). There were more side-effects seen in the promethazine-treated when compared to the group with ondansetron treatment (P < 0.001). No significant differences were seen in the blood pressures between groups (P > 0.05). Heart rates were reduced in both groups but the changes were insignificant (P > 0.05). The ondansetron-treated group showed a greater need for re-administration of the medication (50.6% vs. 27.1%). The relief score was significantly higher in the ondansetron-treated group compared with the group received promethazine (P < 0.001). The time to become asymptomatic showed no statistically significant difference between groups (p = 0.28). CONCLUSION: Our results indicated that while promethazine cures peripheral vertigo more efficiently, ondansetron is more beneficial for the improvement of nausea and vomiting.
RCT Entities:
BACKGROUND: Vertigo is a common annoying complaint needing emergent treatment. There are various treatment options for this condition with different outcomes and side effects. OBJECTIVES: Assessment and comparison of the effectiveness of Ondansetron and Promethazine in the treatment of acute peripheral vertigo. MATERIALS AND METHODS: This clinical trial was conducted in an academic hospital in the north of Iran in 2017. A total of 170 eligible patients were randomly allocated to groups A: received intramuscular (IM) promethazine; and B: received intravenous (IV) Ondansetron, using quadripartite blocks. The severity of vertigo, nausea, blood pressure, heart rate, side-effects, need for re-administration, and the time to become asymptomatic were assessed before the injections, 30 min after and 2 h after the injections. RESULTS: Excellent improvement in vertigo occurred in both groups (P < 0.001), with a more significant reduction in the promethazine-treated group (P < 0.001). Nausea was reduced more significantly in the ondansetron-treated group (P < 0.05). There were more side-effects seen in the promethazine-treated when compared to the group with ondansetron treatment (P < 0.001). No significant differences were seen in the blood pressures between groups (P > 0.05). Heart rates were reduced in both groups but the changes were insignificant (P > 0.05). The ondansetron-treated group showed a greater need for re-administration of the medication (50.6% vs. 27.1%). The relief score was significantly higher in the ondansetron-treated group compared with the group received promethazine (P < 0.001). The time to become asymptomatic showed no statistically significant difference between groups (p = 0.28). CONCLUSION: Our results indicated that while promethazine cures peripheral vertigo more efficiently, ondansetron is more beneficial for the improvement of nausea and vomiting.
Authors: Giulio Di Mizio; Gianmarco Marcianò; Caterina Palleria; Lucia Muraca; Vincenzo Rania; Roberta Roberti; Giuseppe Spaziano; Amalia Piscopo; Valeria Ciconte; Nunzio Di Nunno; Massimiliano Esposito; Pasquale Viola; Davide Pisani; Giovambattista De Sarro; Milena Raffi; Alessandro Piras; Giuseppe Chiarella; Luca Gallelli Journal: Int J Environ Res Public Health Date: 2021-12-08 Impact factor: 3.390