scholarly journals Intravenous Granisetron, Ondansetron and Metoclopramide in the Prevention and Treatment of Post Operative Nausea and Vomiting after Laparoscopic Cholecystectomy - A Comparative Study

2009 ◽  
pp. 20-27
Author(s):  
Sabina Yeasmeen ◽  
Rubina Yasmin ◽  
AKM Akhtaruzzaman ◽  
UH Shahera Khatun
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
General Anaesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Patients Satisfaction ◽  
Group I ◽  
Prevention And Treatment ◽  
Post Operative Nausea ◽  
Rescue Antiemetic

Postoperative nausea and vomiting are the common morbidity after general anaesthesia and surgery. 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. 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. In the recovery room occurrence of nausea and vomiting was assessed for 24 hours. The incidence of emesis free (no nausea) was significantly higher in patients who received Ganisetron (90.0%, 27/ 30) than in those who received Ondansetron [(66.7%, 20/30), p=0.028] or metoclopramide [(40.0%, 12/30), p= 0.000].The incidence of vomiting free was significantly higher in patients who received Granisetron (93.3%, 28/30) than in those who received Ondansetron [73.3%, 22/30), p= 0.037] or Metoclopramide [46.7%, 14/30), p= 0.000]. Granisetron was associated with greater patients' satisfaction than Ondansetron and Metoclopramide 40%, 20% and 10% of patients respectively. No need for another rescue antiemetic medication was achieved in 86.7% of patients with granisetron, 70.60% with Ondansetron and 53.3% with Metoclorpramide. The haemodynamic variables, heart rate, blood pressure, SpO2 were recorded carefully in different time intervals. There was no significant difference among the study. So, it can be concluded that Granisetron is more effective than Ondansetron and Metoclopramide in the prevention and treatment of postoperative nausea and vomiting after laparoscopic cholecystectomy. Journal of BSA, Vol. 19, No. 1 & 2, 2006 p20-27

scholarly journals Comparative study of acupressure wristband versus palonosetron for prophylaxis of postoperative nausea and vomiting in elective laparoscopic cholecystectomy under general anaesthesia

2016 ◽  
Vol 5 (1) ◽  
pp. 96 ◽  
Author(s):  
Suchismita Naik ◽  
Shweta Kujur ◽  
Miltan Debbarma ◽  
Miltan Debbarma ◽  
Madhumita G. Murthy
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
General Anaesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
P Value ◽  
Double Blind Study ◽  
Post Operative Nausea ◽  
Rescue Antiemetic ◽  
Wrist Bands

Background: Postoperative nausea and vomiting (PONV) is common complication after general anesthesia and surgery. This randomized double-blind study was designed to compare the effects of acupressure wrist bands and palonosetron for the prevention of post-operative nausea and vomiting (PONV) in laparoscopic cholecystectomy under general anaesthesia.Methods: Sixty ASA I and II patients undergoing elective laparoscopic surgeries under general anaesthesia were divided into two groups. In Group A patients, acupressure wrist bands were applied on p6 point on both hands half an hour before induction. Group P patients received inj. palonosetron 0.075 m.g. i.v. just before induction. Anaesthesia technique was standardized. Post-operatively patients were monitored for nausea, retching or vomiting upto 24 hours. If patients vomited more than once, they were given inj. Metoclopramide 10mg as rescue antiemetic. Efficacy of drugs was compared using Chi square test. ‘p’ value of <0.05 is considered significant.Results: The incidence of PONV and requirement of rescue antiemetic were lower in palonosetron group than acupressure wrist band group.Conclusions: Palonosetron is more effective than acupressure wrist band for prophylaxis of post- operative nausea and vomiting in the patients undergoing laparoscopic cholecystectomy under general anaesthesia, but acupressure wrist band can also be used as an alternative non-pharmacological method.

scholarly journals The effect of low dose midazolam in addition to ondansetron on post-operative nausea and vomiting in laparoscopic cholecystectomy – a comparative study

2014 ◽  
Vol 24 (1) ◽  
pp. 8-12
Author(s):  
MM Masum-Ul Haque ◽  
Montosh K Mondal ◽  
S Afroz ◽  
SS Akhter ◽  
Abdul Hye ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Low Dose ◽  
Postoperative Nausea And Vomiting ◽  
Group Iv ◽  
Nausea And Vomiting ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
Post Operative Nausea

Background Nausea, retching and vomiting are among the most common postoperative complaints. Premedication with low dose midazolam in addition to ondansetron is more effective in controlling postoperative nausea and vomiting. Objectives This study was designed to observe the effect of low dose midazolam 7.5mg in addition to ondansetron 4mg on postoperative nausea and vomiting in laparoscopic cholecystectomy. Methods 100 patients of ASA grade I and II, age range 30-50 years and weight 50-70 kg were randomly selected by a blind envelop method. They were equally divided into four groups of 25 patients in group each. Group I received vitamin, Group II ondansetron 8mg, Group III ondansetron 8mg and midazolam 7.5mg and Group IV ondansetron 4mg and midazolam 7.5 mg orally one hour before operation. In the recovery room occurrence of nausea and vomiting was assessed for 24 hours. Results The incidence of nausea was in vitamin Group I 64%, in ond8 group II 32%, in ond8+mid7.5 group III 24% and in ond4+mid7.5 group IV 24%. The incidence among the groups was highly significant (p=0.008). The incidence of vomiting was in vitamin Group I 16%, in ond8 group II 16%, in ond8+mid7.5 group III 8% and in ond4+mid7.5 group IV 8%. The difference among the groups were not significant (p=0.808). Conclusion Low dose midazolam 7.5mg in addition to ondansetron 4mg is more effective in controlling postoperative nausea and vomiting in laparoscopic cholecystectomy. DOI: http://dx.doi.org/10.3329/jbsa.v24i1.19793 Journal of Bangladesh Society of Anaesthesiologists 2011; 24(1): 8-12

scholarly journals A Comparative Study Between Palonosetron and Granisetron to Prevent Postoperative Nausea and Vomiting after Laparoscopic Cholecystectomy

2018 ◽  
Vol 24 (2) ◽  
pp. 118-123
Author(s):  
SMA Taher ◽  
Jamil Raihan ◽  
M Abu Zahid ◽  
AK Azad ◽  
MI Alam ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
General Anaesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Economic Effects ◽  
Nausea And Vomiting ◽  
Peritoneal Closure ◽  
Elective Laparoscopic Cholecystectomy ◽  
Elective Procedure ◽  
Post Operative Nausea

Post operative nausea and vomiting is a frequent complication following general anaesthesia and surgery. There is frequently the case of great distress to patient and it is often the worst memory, uncomfortable of their hospital stay. Prolonged post operative nausea and vomiting may cause unexpected physical, metabolic, psychological and economic effects on the patients which slow down their recovery and reduce their confidence in future surgery and anaesthesia. In the present study, we have the incidence of post operative nausea and vomiting in sixty (60) patients undergoing for elective procedure under general anaesthesia. The patients were randomly divided into two groups (group- P, group- G) of thirty (30) patients each.The Patients of group ‘P’ were received intravenous Inj. Palonosetron 75μg and group ‘G’ received intravenous Inj. granisetron 2.5mg (2.5ml) bolus over 30 second just before peritoneal closure. Both group received a standard general anaesthesia. Postoperative analgesia was provided with per rectal diclofenac suppository (50mg) and Inj. Ketorolac Tromethamine 30mg 8 hourly. In the recovery, postoperative room occurrence of nausea and vomiting was assessed for 24 hours. The incidence of post operative nausea and vomiting was reduced in both groups significantly but comparison between these two groups for prevention of PONV(postoperative nausea and vomiting) following elective laparoscopic cholecystectomy surgery is similar. Palonosetron has more prolonged effect than granisetron. There was no evidence of any adverse side effects and whole of the post operative period was smooth.TAJ 2011; 24(2): 118-123

scholarly journals Post operative nausea and vomiting, its causes, and the way of its prevention and treatment

2021 ◽  
Vol 6 (1) ◽  
pp. 1405-1415
Author(s):  
Surendra Maharjan ◽  
Zhang Bing
Keyword(s):  
Risk Factor ◽  
General Anaesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Modal Approach ◽  
Anaesthetic Care ◽  
Prevention And Treatment ◽  
Post Operative Nausea ◽  
Antiemetic Medication

Postoperative nausea and vomiting is still occurring in one third of the patient undergoing surgery under general anaesthesia even after following the guidelines and using multi modal approach for its prevention. Lots of studies have been done for its prevention but very few studies are done for its treatment in Post anaesthetic care unit after the failure of prophylaxis. The purpose of this article is to know about the risk factor, incidence of nausea and vomiting after surgery, its mechanism, available medication (pharmacological and nonpharmacological), reducing risk factor, and mainly to know about the method of using the antiemetic medication in PACU after the failure of the prophylactic medication.

scholarly journals Post operative nausea and vomiting after laparoscopic cholecystectomy: comparison of prophylactic effect of dexamethasone with ondansetron

2014 ◽  
Vol 24 (2) ◽  
pp. 60-64
Author(s):  
M Younus Ali ◽  
Raihan Uddin ◽  
Amirul Islam ◽  
Mustafa Kamal ◽  
SM Rafiqul Islam ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Vital Signs ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Group A ◽  
The Difference ◽  
Prophylactic Use ◽  
Group B ◽  
Post Operative Nausea

Background Postoperative nausea and vomiting after laparoscopic cholecystectomy under general anaesthesia are an unpleasant,distressing effects. Prophylactic use of dexamethesone reducing this effects. Objective This study was designed to compare of dexamethasone and ondansetron for prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. Methods Sixty patients who underwent laparoscopic cholesystectomy were randomly allocated into two groups. Group A(n=30) patients received 8mg dexamehtasone intravenously and Group B(n=30) patients received 8mg ondansetron intravenously one minute before induction of anaesthesia. All patients received standard general anaesthesia.Perioperative vital signs and postoperative nausea and vomiting were recorded. Results The incidence of nausea was 13.4% in group A, 16.7% in group B(p>0.05) and vomiting was 6.6% in Group A, 13.4% in group B(p>0.05). The difference among the groups was not statistically significant. Conclusion Intravenous dexamethasone was better to ondansetron in prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. DOI: http://dx.doi.org/10.3329/jbsa.v24i2.19803 Journal of Bangladesh Society of Anaesthesiologists 2011; 24(2): 60-64

scholarly journals COMPARATIVE EVALUATION OF SINGLE DOSE PALONOSETRON AND GRANISETRON IN MIDDLE EAR SURGERIES FOR PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING.

2020 ◽  
pp. 39-42
Author(s):  
Anjali P. Savargaonkar ◽  
Dipakkumar H. Ruparel ◽  
Uttam Patil
Keyword(s):  
Single Dose ◽  
Middle Ear ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Post Operative Nausea ◽  
Rescue Antiemetic

Background and aims: Palonosetron 5HT 3 antagonist have been evaluated in delayed chemotherapy induced nausea and vomiting but its antiemetic efficacy after middle ear surgery is less clear which is high risk for post operative nausea and vomiting.( PONV). This study aimed to evaluate whether Palonosetron conferred any advantage over Granisetron in terms of duration of prophylaxis and its effect on the incidence and severity of PONV in patients undergoing middle ear surgeries (MES) when used as single dose prophylactic antiemetic. Methods: One hundred ASA I and II patients of either gender aged 18 to 60 were randomly assigned into group P (Palonosetron n=50) or group G( Granisetron n=50), by computerised randomisation. Analysis was done in terms of incidence and severity of nausea, vomiting and rescue antiemetic usage till 72 hours of surgery. Results: During 72 hours, group P had more number of complete responders than in group G (56% vs. 34%). This difference was more significant after 24hours. 50% of patients in group G as against 28% in group required rescue antiemetic. Conclusion: Single dose prophylactic Palonosetron 0.075 mg and 2.5 mg Granisetron conferred similar protection against postoperative nausea and vomiting for initial six hours postoperatively but Palonosetron was more effective than Granisetron for long term prophylaxis over 72 hours against PONV after MES without significant adverse effects.

scholarly journals Antiemetic prophylaxis against postoperative nausea and vomiting with ondansetron-dexamethasone combination compared to ondansetron or dexamethasone alone for patients undergoing laparoscopic cholecystectomy

1970 ◽  
Vol 6 (3) ◽  
pp. 319-328 ◽  
Author(s):  
B Gautam ◽  
BR Shrestha ◽  
P Lama ◽  
S Rai
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Complete Response ◽  
Nausea And Vomiting ◽  
General Anaesthetic ◽  
Antiemetic Prophylaxis ◽  
Dexamethasone Group ◽  
Group D ◽  
Rescue Antiemetic

Background: Postoperative nausea and vomiting (PONV) is a common distressing experience in patients following laparoscopic surgeries. This study was aimed at comparing the efficacies of Ondansetron-Dexamethasone combination with each drug alone as a prophylaxis against PONV in patients after elective laparoscopic cholecystectomy done under general anaesthesia. Materials and methods: Hundred and fifty ASA I and II patients, aged 23 to 65 yrs, were enrolled in this prospective, randomized, double-blind trial to receive one of three treatment regimens: 4 mg Ondansetron (Group O), 8 mg Dexamethasone (Group D) or 4 mg Ondansetron plus 8 mg Dexamethasone (Group OD) (n=50 for each). A standardized balanced general anaesthetic technique was employed. Any episode of PONV and need for rescue antiemetic were assessed at six, 12 and 24 hrs post operation. Complete response was defined as no PONV in 24 hrs and need for rescue antiemetic was considered as failure of prophylaxis. Pain scores, time to first analgesia demand, amount of Meperidine consumption, adverse event(s) and duration of hospital stay were recorded. Results: Complete response occurred in 66.7, 66.0 and 89.4% in Groups O, D and OD respectively. Rescue antiemetics were required in 29.2, 31.9 and 8.5% of patients in Groups O, D, and OD respectively. Significantly high incidence of vomiting and failure of prophylaxis (19.1%) occurred in group D during the first six hrs (P=0.023 versus O & 0.008 versus OD). More frequent antiemetic rescue was required in group O at 6 to 24 hr interval as compared to group OD (P=0.032). Conclusion: Combination of Ondansetron and Dexamethasone is better than each drug alone in preventing PONV after laparoscopic cholecystectomy. Dexamethasone alone is significantly less effective in preventing early vomiting compared to its combination with Ondansetron; whereas Ondansetron alone is less effective against late PONV as compared with combination therapy. Key words: Antiemetic prophylaxis; Dexamethasone; laparoscopic cholecystectomy; Ondansetron; postoperative nausea and vomiting (PONV) doi: 10.3126/kumj.v6i3.1706 Kathmandu University Medical Journal (2008), Vol. 6, No. 3, Issue 23, 319-328

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