Prospective, Randomized, Double Blind Study to Compare the Efficacy and Safety of Granisetron Versus Ondansetron in Prevention of Post Operative Nausea and Vomiting in Patients Undergoing Elective Laparoscopic Cholecystectomy Under General Anaesthesia (original) (raw)
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Birat Journal of Health Sciences
IntroductionLaparoscopic cholecystectomy has higher incidence of postoperative nausea and vomiting (PONV). In routine practice single dose of drug is given prophylactically during the surgery.ObjectiveThis study aimed to compare the antiemetic efficacy of two different 5-hydroxytryptamine-3 (5HT3) receptor antagonists, Ondansetron and Granisetron when given prophylactically to patients undergoing laparoscopic cholecystectomy.MethodologyIt was a randomized, single blind study, conducted in 75 patients undergoing laparoscopic cholecystectomy. Patients were divided into two groups: Group O and Group G. Patients in group O were given 0.1 mg/kg Ondansetron intravenously (IV) and patients in Group G were given 0.04 mg/kg Granisetron. The standard general anesthetic technique was administered to all the patients. Episodes of nausea, retching and vomiting were assessed during the first 24 hours after anesthesia. Collected data was applied with appropriate test in SPSS 16 and overall signif...
IOSR Journal of Dental and Medical Sciences, 2013
Post operative nausea and vomiting (PONV) continue to be frequent occurrences, even when conventional antiemetics are prophylactically used. In a randomized double blind study, 100 female patients scheduled for elective laparoscopic cholecystectomy under general anaesthesia were divided into 2 groups of 50 patients each and received 0.1mg/Kg of Ondansetron (Group X) or 0.04mg/Kg of Granisetron (Group Y) preoperatively. Patients were observed for 24 hours post operatively and interpretation of symptoms of nausea and vomiting was done according to Gan and Alexander scale (0-2). 80% of patients in Group Y and 48 % patients in Group X did not experience PONV; the difference was statistically significant (p<0.001). 2 patients (4%) in Group Y and 15patients (30%) in Group X required rescue antiemetic medication during the 24 hour study period. The difference was found to be highly significant (p<0.001) The difference in the incidence of PONV between the two groups after 6 hours to 24 hours was highly significant (p<0.001). It was concluded that prophylactic administration of Granisetron is more effective than Ondansetron, in reducing in incidence of PONV with prolonged effects.
JNMA; journal of the Nepal Medical Association
Laparoscopic surgeries are known to be associated with a higher incidence of postoperative nausea and vomiting (PONV). Prophylaxis of PONV is usually achieved with a single-dose antiemetic drug administered during the surgical procedure. The aim of this study was to compare the antiemetic efficacy of two different 5-hydroxytryptamine-3 (5HT3) receptor antagonists, ondansetron and granisetron when given prophylactically to patients undergoing laparoscopic cholecystectomy. It was a randomized, double blind study, conducted in 90 patients. Patients were divided into two groups: Group A and Group B with 45 patients in each group. Patients in groupA were given 100 microgram/kg ondansetron intravenously (IV), and patients in Group B were given 40 microgram/kg granisetron. Both the drugs were diluted in 10 ml of 0.9% NaCl and were given at the end of surgery. The standard general anesthetic technique was administered to all the patients. Episodes of nausea, retching and vomiting were asses...
International Journal of Research in Medical Sciences, 2016
Despite advances in anaesthesia care postoperative nausea and vomiting (PONV) remains a vexing problem. PONV is distressing adverse effect after anaesthesia and surgery, resulting in significant morbidity due to acute discomfort associated with emetic symptoms and longer stays in the recovery room or unexpected hospital admission in ambulatory settings. Patients reports that avoidance of PONV is of greater or equal concern as avoidance of postoperative pain and they are willing to ABSTRACT Background: Postoperative nausea and vomiting (PONV) remains a vexing problem despite of advances in anaesthesia care. PONV is distressing adverse effect after anaesthesia and surgery, resulting in significant morbidity due to acute discomfort associated with emetic symptoms and longer stays in the recovery room or unexpected hospital admission in ambulatory settings. Methods: A prospective, randomized, double blind comparative study was conducted to compare the efficacy and adverse effects of injection granisetron 40µg/kg as a single dose and injection granisetron in two different doses (20µg/kg and 40µg/kg) in combination with dexamethasone 160µg/kg for prevention of postoperative nausea and vomiting in patients undergoing general anaesthesia for elective laparoscopic cholecystectomy. Results: Nausea and vomiting were observed postoperatively at 0, 1, 2, 4, 8, and 24 consecutive hours after patient responded to verbal commands. Intensity of nausea graded verbally with an eleven point score (0-10) with those patients who scored their nausea as zero were termed nausea free, and 10 being most severe. Nausea scores when patient complains of nausea & if patient demand rescue antiemetic for nausea was noted down along with adverse effects if any. The data was analysed by ANOVA followed by unpaired't' test, Chi-square/Fischer exact test or Kruskal Wallis Test. Conclusions: Granisetron as a single agent in dose 40µg/kg is effective as prophylactic antiemetic in preventing PONV in laparoscopic cholecystectomy whereas addition of dexamethasone 160µg/kg to granisetron significantly increases antiemetic efficacy of the granisetron in both the doses i.e. 20µg/kg and 40µg/kg without increasing any side effect. Granisetron 40µg//kg+injection dexamethasone 160µg/kg is best for antiemetic prophylaxis in highly emetogenic surgeries like laparoscopic cholecystectomy. Granisetron 20µg/kg + injection dexamethasone can be cost effective alternative for routine antiemetic prophylaxis compared to granisetron 40µg//kg and granisetron 40µg//kg+ injection dexamethasone for all patients undergoing laparoscopic cholecystectomy.
Journal of the Bangladesh Society of Anaesthesiologists, 2009
Postoperative nausea and vomiting are the common morbidity after general anaesthesia and surgery 1. One of the essential goals of anaesthetic management is to prevent postoperative nausea and vomiting. The consequence of prolonged postoperative nausea and vomiting (PONV) ranges from unexpected admission of day patients with its economic implications to physical, metabolic and psychological effects on the patients which slow their recovery and reduced their confidence in future surgery and anaesthesia 2. The present study was designed to compare the efficacy of Granisetron with that of Ondansetron and Metoclopramide in the treatment and prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. This study was also done to observe the incidence of nausea and vomiting in the postoperative period, to observe the requirement of rescue antiemetic, to find out the haemodynamic stability, saturation of arterial oxygen in these groups of subject and to detect the patients satisfaction by verbal rating scale after 24 hours of surgery. A total number of 90 patients, sex female, age range 30-50 years undergoing laparoscopic cholecystectomy were selected. They were equally divided into three groups of 30 patients. They received a standard general anaesthesia. Group I received injection Granisetron (1mg), Group II received injection Ondansetron (8mg), Group III received injection Metoclopramide (10mg) 10 minutes before reversal of anaesthesia. Postoperative analgesia was provided with injection pethidine (1.5mg/kg/bd.wt.) intramuscularly 8 hourly.
Surgical Endoscopy, 2008
Background Laparoscopic cholecystectomies are associated with an appreciably high rate of postoperative nausea and vomiting (PONV). This study was designed to compare the effectiveness of ondansetron, granisetron, and dexamethasone for the prevention of PONV in patients after laparoscopic cholecystectomy. Methods A total of 80 American Society of Anesthesiologists (ASA) physical class I-II patients scheduled for laparoscopic cholecystectomy were included in this randomized, double blind, placebo-controlled study. All patients received a similar standardized anesthesia and operative treatment. Patients were randomly divided into four groups (n = 20 each). Group 1, consisting of control patients, received 0.9% NaCl; group 2 patients received ondansetron 4 mg i.v.; group 3 patients received granisetron 3 mg i.v.; and group 4 patients received dexamethasone 8 mg i.v., all before the induction of anesthesia. Both nausea and vomiting were assessed during the first 24 h after the procedure. Results The total incidence of PONV was 75% with placebo, 35% with ondansetron, 30% with granisetron, and 25% with dexamethasone. The incidence of PONV was significantly less frequent in groups receiving antiemetics (p \ 0.05). The differences between dexamethasone, granisetron, and ondansetron were not significant. Conclusions Prophylactic dexamethasone 8 mg i.v. significantly reduced the incidence of PONV in patients undergoing laparoscopic cholecystectomy. Dexamethasone 8 mg was as effective as ondansetron 4 mg and granisetron 3 mg, and it was more effective than placebo.
Journal of Evolution of Medical and Dental Sciences, 2019
BACKGROUND Postoperative nausea and vomiting (PONV) have been described as the "big little problem" 1,2 for anaesthesiology for laparoscopic surgery. Commonest cause of morbidity after aesthesia and surgery are pain and postoperative nausea vomiting. 3,4,5 METHODS Institutional ethical committee clearance and written informed consent were obtained from 60 female patients of American Society of Anaesthesiologists physical status I and II, aged between 18 to 65 years, weighing about 50-60 Kg., height 150 to 160 cm, scheduled for laparoscopic cholecystectomy (duration < 90 minutes) under general anaesthesia in this prospective, randomised, double blind controlled study. Patients coming to operation theatre were divided by computer generated randomization in to two groups of 30 each, Group-A (n=30) and Group-B (n=30). A person, who was blind to the randomisation schedule, was administered the study drug 1 minute prior to other I.V. drugs. One of the following regimens, for Group A patients: Ondansetron 4 mg in 2 ml or for Group B patients: Dexamethasone 8 mg in 2 ml were administered. After preoxygenation, general anaesthesia was administered, pneumoperitoneum created, laparoscopic cholecystectomy done, and anaesthesia reversed. For post-operative analgesia Paracetamol (1000 mg) I.V. was administered. All patients were observed post operatively by noting vital signs and complications, if any. All episodes of PONV (nausea, vomiting, retching) were recorded for 12 hrs post operatively. Rescue drug Inj. Metoclopramide 10 mg I.V. was given, if required. All data from each patient was obtained and tabulated. RESULTS The age, weight, height, ASA status and duration of surgery of the patients included in study group (p ≤0.05) were comparable and there was no significant statistical difference among the data collected during the study. Incidence of nausea is higher in both groups in the first hour though it is not statistically significant. Within 3-6 hours, patients receiving Dexamethasone had higher incidence of nausea, but it is not statistically significant. Incidence of retching is higher in both groups in the first hour. It is not statistically significant. Vomiting was more in the first 3 hours in both groups. It was not statistically significant. Need for rescue drug (Inj. metoclopramide 10 mg I.V.) was similar in both groups. CONCLUSIONS Ondansetron is as effective as Dexamethasone in reducing the incidence of nausea and vomiting in post-operative period of laparoscopic cholecystectomy and has minimal side effects.
2016
Postoperative nausea and vomiting (PONV) after laproscopic cholecystectomy remains a common problem in spite of introduction of newer antiemetics with better efficacy and safety profiles. None of the available antiemetics is entirely effective, perhaps because most of them act through the blockade on a particular type of receptor. The addition of adjuvants like dexamethasone and promethazine to antiemetics like granisetron can improve the outcome. However, lack of knowledge limits its acceptance. The aim of the present study was to compare the effects of dexamethasone and promethazine as adjuvant to granisetron for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy. In Method 120 patients, aged 25-55 years, scheduled for elective cholecystectomy were enrolled in a randomized, double blinded manner and assigned to one of three treatment regimens: granisetron 2mg + 5ml normal saline (Group I), granisetron 2mg + dexamethasone 8mg (Group ...