scholarly journals Comparison of Granisetron and Granisetron Plus Dexamethasone for the Prevention of Post-operative Nausea and Vomiting (PONV)

2007 ◽  
Vol 8 (Number 1) ◽  
pp. 21-27
Author(s):  
K S Islam ◽  
S M Bakhtiar ◽  
M A Mannan

77tere is a high incidence of postoperative nausea and vomiting (PONV) in patients undergoing surer, and anaesthesia. Many factors are claimed to be responsible for POW. This stad.v MU designed to compare the effectiveness of grornsetron pits desomethasone with gran isetron alone to prevent post-operative nausea and vomiting. In this randomised double blind study. sixty patients were divided into two egnal groups ( n=30 each ). Patients in Group A received granisetron 40 pion per kg before inductor of anaesthesia and those in Group B received gmnisetron 40 pp: per kg phis devamethasone 8 nog before induction of anaesthesia. All the patients were observed for post-opera tive nausea and vaniting for 24 hours (0-6 hours in the recovety room and 18 hours in ward or cabin). A significant difference was found in complete response, defined as no pos,opertalve nausea and vomiting. between patients of graniserron alone group and those of granisetron pins dexamethasone combination group. The combination of grontsoron plus de.tainethasone is considered to be more effective for prevention of post-operative nausea and vomiting.

2021 ◽  
pp. 72-74
Author(s):  
Anusha K ◽  
Sherin bright

BACKGROUND : Palonosetron is a new potent 5-hydroxytryptamine 3 antagonist. Although used for chemo induced emesis, data is lacking for PONV. The high incidence of nausea and vomiting after breast surgery is well documented. This study compared the effects of i.v.ondansetron and palonosetron administered at the time of induction for preventing postoperative nausea and vomiting (PONV) in these high-risk patients . The aim was to compare Onda METHODS : nsetron 8 mg and Palonosetron 0.075mg administered intravenously for prevention of post operative nausea and vomiting in patients undergoing modied radical mastectomy 24 hours postoperatively, by a randomised , controlled, double blind study. 70 female non smoking patients scheduled for elective modied radical mastectomy were, allocated randomly into 2 groups . Patients received either Palonosetron 0.075mg (GROUP P ) or ondansetron 8mg ( GROUP O ) intravenously, immediately before induction of general anaesthesia. The occurence of nausea, vomiting, retching, need for rescue antiemetics and side effects were monitored for a period of 24 hours after surgery. The compete response rate and overall PONV for 0 - 24 hours were calculated. The demographic prole of the patients were comparable. The RESULTS : incidence of a complete response (no PONV, no rescue antiemetics ) during 0 - 24 hours in post operative period was signicantly high in GROUP P ( 85.7% vs 62.9%, p=0.02) than GROUP O. The incidence of nausea was signicantly low in GROUP P ( 14.3% vs 37.1%). There was no statistically signicant difference between the 2 groups in vomiting, retching, side effects and need for rescue antiemetics. Thus overall PONV was low in GROUP P (14.3% vs 37.1% p = 0.02 statistically signicant.) We conclude that Palonosetron 0.075mg was more effective for preventing PONV in patients undergoing modied radical mastectomy surgery


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Renu Sinha ◽  
Dilip Shende ◽  
Souvik Maitra ◽  
Neeraj Kumar ◽  
Bikash Ranjan Ray ◽  
...  

Aim.Efficacy of granisetron and combination of granisetron and dexamethasone was evaluated for prevention of postoperative nausea and vomiting (PONV) in children undergoing elective strabismus surgery.Methods.A total of 136 children (1–15 years) were included. Children received either granisetron (40 mcg/kg) [group G] or combination of granisetron (40 mcg/kg) and dexamethasone (150 mcg/kg) [group GD]. Intraoperative fentanyl requirement and incidence and severity of oculocardiac reflex were assessed. PONV severity was assessed for first 24 hours and if score was >2, it was treated with metoclopramide. Postoperative analgesia was administered with intravenous fentanyl and ibuprofen.Results.The demographic profile, muscles operated, and fentanyl requirement were comparable. Complete response to PONV in first 24 hours was observed in 75% (51/68) of children in group G and 76.9% (50/65) of children in group GD, which was comparable statistically (p=0.96, Fisher exact test; OR 1.11, 95% CI 0.50, 2.46). Incidence of PONV between 0 and 24 hours was comparable. One child in group G required rescue antiemetic in first 24 hours and none of the children had severe PONV in group GD. There was no significant difference in incidence or severity of oculocardiac reflex.Conclusion.Dexamethasone did not increase efficacy of granisetron for prevention of PONV in elective pediatric strabismus surgery. Registration number of clinical trial wasCTRI/2009/091/001000.


2021 ◽  
Vol 8 (01) ◽  
pp. 12-16
Author(s):  
Koilada Shiv Kumar ◽  
Rajan Anand ◽  
Debasis Bagchi

BACKGROUND Postoperative nausea and vomiting are highly prevalent after ophthalmic surgeries in the paediatric age group. In this randomised, double-blind prospective clinical trial, we studied and compared the efficacy of granisetron and combination of granisetron with dexamethasone to prevent postoperative nausea and vomiting after paediatric ocular surgeries. METHODS Sixty paediatric patients (06 - 12 yrs. of age) undergoing elective ocular surgeries were randomly allocated to one of the two groups of 30 patients each. Group (G) received granisetron 40 mcg kg–1 intravenously as a bolus before induction of anaesthesia. Group (G + d) received granisetron 40 mcg kg–1 & dexamethasone 0.1 mg kg–1 intravenously as a bolus before induction. Student t-test, Fisher exact test were used wherever applicable for statistical analysis using SPSS version 15.0. RESULTS A complete response (defined as no post-operative nausea and vomiting and no need for another rescue antiemetic) was achieved in 63.3 % of patients who received granisetron alone and in 96.7 % of patients who received granisetron plus dexamethasone. We found nil difference in complications between the two groups. CONCLUSIONS We found that addition of dexamethasone to granisetron is more effective and beneficial than granisetron alone in preventing postoperative emesis in 1st 24 hours. KEYWORDS Post-Operative Nausea and Vomiting, Anaesthesia, Granisetron, Dexamethasone


2019 ◽  
Vol 18 (1) ◽  
pp. 23-29
Author(s):  
Bhuwan Raj Kunwar ◽  
Thaneshowr Rijal ◽  
Puja Thapa ◽  
Mallika Rayamajhi ◽  
Biswo Ram Amatya

Introduction: Postoperative Nausea and Vomiting (PONV) is one of the commonest causes of significant morbidity in the patients after laparoscopic cholecystectomy. The purpose of this study was to compare the incidence of PONV when propofol and thiopentone were used as induction agents during laparoscopic cholecystectomy. Methods: A prospective, randomised comparative study was conducted in operation theatre at a tertiary level referral hospital of Nepal. A sample size of 100 ASA I - II patients aged between 18 and 70 years were included and scheduled for elective laparoscopic cholecystectomy. The study population were divided into two groups: Group A (Propofol), n = 50 and Group B (Thiopentone), n = 50. These patients were followed up for the first 24 hours postoperatively for any PONV at 0-6 hrs, 6-12 hrs, 12-24 hrs. Results: Out of the 100 patients, PONV was observed almost similar in both groups. i.e. group A (Propofol) n = 31, (62%) and group B (Thiopentone) n = 26 (52%) with no statistical significance (p value = 0.1998) within the first 24 hours postoperatively in both groups; and no significant difference was observed at the different time intervals viz. at 0-6 hrs (p value 0.262): Group A = 45%; Group B = 40%; 6-12 hrs (p value 0.781): Group A = 17.5%, Group B = 22.5%; 12-24 hrs (p value 1.000) Group A = 0%; Group B = 2.5% when using the Fisher exact test. The mean ages for development of PONV in these two groups were: Group A = 40 years and Group B = 38 years. The p-value was 0.5125 which showed no statistical significance. In our study 76% (n = 38) were females and 24% (n = 12) were males in Group A; while 70% (n = 35) were females and 30% (n = 15) males in Group B. However, there was no statistical difference between the two groups in terms of PONV. Conclusions: The study showed that there was a high incidence of PONV during laparoscopic cholecystectomy. However, there was no significant difference in the incidence of PONV when propofol or thiopentone was used.  


2014 ◽  
Vol 52 (193) ◽  
pp. 682-686 ◽  
Author(s):  
Sabin Gauchan ◽  
Chitra Thapa ◽  
Priyanka Shakya ◽  
Ramesh Bhattarai ◽  
Sajal Shakya

Introduction: Laparoscopic surgeries are known to be associated with a higher incidence of postoperative nausea and vomiting. 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 receptor antagonists, ondansetron and granisetron when given prophylactically to patients undergoing laparoscopic cholecystectomy.Methods: 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 100microgram/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 assessed during the first 24 hours after anesthesia.Results: There was no statistically significant difference for demographic data and duration of surgery among the two groups (P > 0.05). Evaluated nausea and vomiting scores in the first 3hours period revealed that each of the drugs had a similar antiemetic effect (P > 0.05). Between 4–12 hours also the episodes of nausea, retching as well as vomiting were statistically insignificant in both the groups. In the last 12 hours, episodes of nausea, retching and vomiting were significantly higher in ondansetron group.Conclusions: Granisetron, when given prophylactically, resulted in a significantly lower incidence of PONV than ondansetron in the first 24 hours.Keywords: Granisetron; Laparoscopic cholecystectomy; Ondansetron; postoperative nausea vomiting. 


2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Shahnam Sedighmaroufi ◽  
Ali Abbaskhani Davanloo ◽  
Parisa Moradimajd ◽  
Hamidreza Samaee ◽  
Mohammad Lavaie

Background: Postoperative nausea and vomiting (PONV) is still a common complication that occurs frequently at the time of recovery from eye surgery. Objectives: The present study aimed to compare the effect of oral Ondansetron and Ginger on the frequency and severity of postoperative nausea and vomiting in patients undergoing eye surgery. Methods: A total of 148 patients were randomly assigned to Ginger, Ondansetron, and placebo groups. Group A received a Ginger capsule (1,000 mg), group B Ondansetron capsule (16 mg), and group C placebo capsule with 30 ml water, one hour before surgery. The frequency of nausea and vomiting and the severity of nausea were recorded immediately after recovery, 1, 2, and 4 hours after recovery. Also, some side effects following prescription such as headache, stomach ache, dizziness, and cardiac arrhythmias were recorded. Results: Of the 148 participants, 54% were men, and 46% were women. The average age was in group Ginger (36.14 ± 2.17), group Ondansetron (36.24 ± 2.49), and group placebo (36.24 ± 2.20). There was no significant difference in the frequency of vomiting between the three groups immediately after recovery (P = 0.19) and 4 hours after surgery (P = 0.18). However, the frequency of vomiting in Ginger and Ondansetron groups 1 and 2 hours after the surgery was significantly lower than that in the control group (P = 0.003). No significant difference was observed in the severity of nausea between the three groups at certain times (P > 0.05). There was no significant difference in terms of the need for injection antiemetic drugs after surgery (P = 0.2). Conclusions: Ginger and Ondansetron can reduce the frequency of vomiting. However, Ginger was more effective, safer, and less expensive than Ondansetron; therefore, it may be a better substitute for Ondansetron to prevent PONV.


1994 ◽  
Vol 22 (5) ◽  
pp. 576-579 ◽  
Author(s):  
M. R. C. Rodrigo ◽  
R. C. H. Campbell ◽  
J. Chow ◽  
C. K. A. Tong ◽  
E. Hui ◽  
...  

The efficacy and safety of ondansetron in preventing postoperative nausea and vomiting following minor oral surgery was evaluated in a prospective randomized double-blind study. Of a total of seventy-seven patients, randomly 38 had 4 mg of ondansetron and 39 had normal saline as placebo intravenously immediately prior to induction of anaesthesia. A standard general anaesthetic with thiopentone, suxamethonium, fentanyl, nitrous oxide and isoflurane was employed. Postoperatively nausea was assessed verbally and on a visual analog scale at 1, 4 and 24 hours from the time of awakening. Episodes of vomiting were recorded. Eight patients (21.1%) in the ondansetron group compared to 19 (48.7%) in the placebo group had nausea (P < 0.05) and 1 (2.6%) in the ondansetron group compared with 9 (23.1%) in the placebo group vomited (P < 0.05). Patients who vomited twice or more and the number who required a rescue antiemetic were significantly fewer in the ondansetron group (P < 0.05). Cardiovascular parameters were stable and showed no significant difference in the two groups. There were no significant adverse effects that could be directly attributable to ondansetron.


Author(s):  
Deep Chilana ◽  
Bhawana Rastogi ◽  
Abhishake Kumar ◽  
Brig V.P. Singh ◽  
Richa Arora ◽  
...  

Background: In laparoscopic surgeries, insufflation with carbon dioxide triggers vagal afferents on the bowel and peritoneum which induces emesis by activating the vomiting center. It is hypothesized that combined antiemetics with different sites of activity would be more effective than one drug alone for the prophylaxis against PONV. So, the present study was planned to compare the efficacy of granisetron, dexamethasone and combination of granisetron with dexamethasone to prevent PONV.Methods: This randomized prospective double-blind study was performed on 120 patients, aged between 18 and 58 years of ASA physical status I and II of either sex undergoing laparoscopic surgeries under general anesthesia. Patients were randomized in three groups, group I (granisetrone 2 mg I.V.), group II (dexamethasone) 8 mg I.V., group III (granisetrone+dexamethasone) 2 mg+8 mg I.V. with 40 patients in each group. Complete response, incidence of nausea, vomiting, and rescue antiemetic were recorded at specified intervals.Results: A complete response (defined as no PONV and no need for another rescue antiemetic) was achieved in 75% of the patients given granisetron, 70% in dexamethasone and in 92.5% of the patients given granisetron plus dexamethasone (P <0.05). The overall cumulative incidences (0-24 hours) of PONV were 10 (25%) in the granisetron, 12 (30%) in the dexamethasone and 3 (7.5%) in the combination group. No difference in adverse events were observed in any of the groups.Conclusions: The prophylactic therapy of granisetron 2 mg plus dexamethasone 8 mg just before induction of anaesthesia is significantly effective in prevention of PONV in patients undergoing laparoscopic surgeries.


2017 ◽  
Vol 126 (2) ◽  
pp. 268-275 ◽  
Author(s):  
Tong J. Gan ◽  
Peter Kranke ◽  
Harold S. Minkowitz ◽  
Sergio D. Bergese ◽  
Johann Motsch ◽  
...  

Abstract Background Two essentially identical, randomized, double-blind, placebo-controlled, parallel-group phase III studies evaluated the efficacy of intravenous amisulpride, a dopamine D2/D3 antagonist, in the prevention of postoperative nausea and vomiting in adult surgical patients. Methods Adult inpatients undergoing elective surgery during general anesthesia and having at least two of the four Apfel risk factors for postoperative nausea and vomiting were enrolled at 9 U.S. and 10 European sites. A single 5-mg dose of amisulpride or matching placebo was given at induction of anesthesia. The primary endpoint was complete response, defined as no vomiting/retching and no use of antiemetic rescue medication in the 24-h postoperative period. Nausea incidence was a secondary endpoint. Results Across the two studies, 689 patients were randomized and dosed with study medication, of whom 626 were evaluable per protocol. In the U.S. study, 46.9% (95% CI, 39.0 to 54.9) of patients achieved complete response in the amisulpride group compared to 33.8% (95% CI, 26.2 to 42.0) in the placebo group (P = 0.026). In the European study, complete response rates were 57.4% (95% CI, 49.2 to 65.3) for amisulpride and 46.6% (95% CI, 38.8 to 54.6) for placebo (P = 0.070). Nausea occurred less often in patients who received amisulpride than those who received placebo. There was no clinically significant difference in the safety profile of amisulpride and placebo; in particular, there were no differences in terms of QT prolongation, extrapyramidal side effects, or sedation. Conclusions One of the two trials demonstrated superiority, while pooling both in a post hoc change to the plan of analysis supported the hypothesis that amisulpride was safe and superior to placebo in reducing the incidence of postoperative nausea and vomiting in a population of adult inpatients at moderate to high risk of postoperative nausea and vomiting.


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