scholarly journals A Comparative Study of Single Dose Dexamethasone versus Ondansetron for control of Post Operative Nausea and Vomiting after High-Risk Surgeries

2020 ◽  
Vol 8 (1) ◽  
pp. 64-70
Author(s):  
Ashwin Joginipally ◽  
Nikhil Mudgalkar
Keyword(s):  
High Risk ◽  
General Anesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Age Group ◽  
Dexamethasone Group ◽  
Group I ◽  
Group Ii ◽  
Post Operative Nausea

The occurrence of postoperative nausea and vomiting is generally associated with anesthesia and surgery. The problem is compounded in cases of high-risk surgeries where the incidence is quite high. The present study was designed to compare the efficacy of Dexamethasone and Ondansetron. Methods: This study was undertaken at the Prathima Institute of Medical Sciences, Naganoor, Karimnagar. In this randomized, open clinical trial, we studied 80 ASA grades I to 1V patients of age group 20-60 years undergoing Laparoscopic Laparotomy, Major Gynecological surgeries, Renal, Shoulder and ENT surgeries under general anesthesia. The patients were randomly divided into two groups, Group I and Group II, each consisting of 80 patients. Group I received 4mg dexamethasone intravenous (IV) just after intubation and group II received 4mg Ondansetron intravenous (IV), just before extubation. Results: The most common age group was 50 – 59 years which had n=45(28.1%) patients out of which group I was n=24(15%) patients and n=21(13.1%) patients. The next common age group was 20 – 29 years out of which n=23 (14.4%) and n=18(11.2%). ondansetron group, early nausea is mild in 6.9%, moderate in 3.8%, and severe in 1.2% of patients. Whereas in the dexamethasone group early nausea is mild in 6.2%, moderate in 4.4%, severe in 1.9% of patients. In the ondansetron group, late nausea is mild in 9.4%, moderate in 3.8%, and severe in 0.6% of patients. Whereas in the dexamethasone group late nausea is mild in 7.5%, moderate in 4.4%, severe in 0.6% of patients. In the ondansetron group, early vomiting is mild in 5.0%, moderate in 0.6%, and severe in 0.6% of patients. Whereas in the dexamethasone group early vomiting is mild in 4.4%, moderate in 1.2%, severe in 0.6% of patients. Conclusion: dexamethasone given intravenously just after intubation and ondansetron given intravenously just before extubation are safe and have similar efficacy in postoperative nausea and vomiting after elective surgeries under general anesthesia having a high risk of PONV

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 Comparison of the Efficacy of Metoclopramide Versus Dexamethasone for the Prevention of Postoperative Nausea Vomiting during General Anesthesia

2021 ◽  
pp. 163-168
Author(s):  
Sunil Arjan ◽  
Naila Zahoor ◽  
Kenza Nadeem ◽  
Farah Liaquat ◽  
Tariq Hussain Mughal ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Female Ratio ◽  
Post Operative Nausea ◽  
Group D ◽  
Male To Female

Objective:To evaluate the efficacy of Metoclopramide versus Dexamethasone for prevention of postoperative nausea and vomiting during general anesthesia. Study Design:This is a Randomized control trial (RCT) study. Setting: Study carried out at Department of Anaesthesiology, Surgical Intensive Care Unit and Pain Management, Clinic, Dow University of Health Sciences and  Dr. Ruth Pfau  Hospital Karachi, from December 2018 to June 2019. Materials and Methods:110 patients undergoing elective surgeries, who fulfilled the inclusion criteria and gave informed consent were included in the study. They were randomly assigned to either group M or group D, with 55 patients in each group. All patients were then administered either intravenous dexamethasone (8mg) in group D or intravenous metoclopramide (10mg) in group M at the time of induction of anesthesia. The main outcome measure was postoperative nausea and vomiting, at the end of 6th hour postoperatively. The SPSS version 21 was applied to the data. Results: Majority of the patients 66 (60%) were of age 35 years or less. Mean age of the patients was 35.09±11.55 years. There were more females than males, with male to female ratio being 1:1.03. Overall, in patients receiving metoclopramide, 12(21.8%)  had postoperative nausea and vomiting, while in patients who received dexamethasone, only 4 (7.3%) patients had post-operative nausea and vomiting. When comparing two groups, there was statistically significant (p= 0.02) reduced postoperative nausea/vomiting among those patients who had received intravenous dexamethasone. Conclusion: Intravenous dexamethasone is more effective than Metoclopramide in preventing postoperative nausea and vomiting in patients during general anesthesia.

scholarly journals Evaluation of the efficacy of Granisetron over Droperidol in the prevention of Postoperative Nausea and Vomiting following open Cholecystectomy

JMS SKIMS ◽  
2011 ◽  
Vol 14 (1) ◽  
pp. 11-14
Author(s):  
Abdul Qayoom Lone ◽  
Shruti Sharma ◽  
Mohamad Ommid ◽  
Showkat H Nengroo ◽  
Imtiyaz Naqash
Keyword(s):  
General Anesthesia ◽  
Postoperative Nausea ◽  
Open Cholecystectomy ◽  
Randomized Study ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Physical Status ◽  
Double Blind ◽  
Post Operative Nausea ◽  
To Receive

BACKGROUND: Post operative nausea and vomiting (PONV) continue to be frequent occurrences, even when conventional antiemetics are prophylactically used. OBJECTIVE: To compare the efficacy of Granisetron over Droperidol in the prevention of PONV in patients undergoing elective open cholecystectomy under general anesthesia. MATERIAL & METHODS: In this double blind randomized study, 100 adult patients with physical status ASA I and II, (age, 20-60 years), were randomly allocated into two groups, X or Y, to receive either injection Granisetron hydrochloride (3 mg i/v) or Droperidol (2.5 mg i/v), 5 min prior to induction of general anesthesia. The incidence of nausea and vomiting was recorded every six hourly for a period of 24 hour after the surgery. RESULTS: 6 (12%) patients in the granisetron group and 20 (40%) patients in the Droperidol group reported an emetic episode, (p = 0.002); the incidence of PONV in the total 24 hr period after the surgery, 54% in the granisetron group and 76% in Droperidol group (p = 0.022) CONCLUSIONS: It was found that granisetron is superior to Droperidol in the prevention of postoperative nausea and vomiting. JMS 2011;14(1):11-14

scholarly journals Aggressive Prophylactic Treatments for Postoperative Nausea and Vomiting Improve Outcomes in Pediatric Adenotonsillectomy Procedure

2020 ◽  
Vol 25 (4) ◽  
pp. 303-308
Author(s):  
Tatyana Demidovich ◽  
Orlando Perez-Franco ◽  
Marco Silvestrini-Suarez ◽  
Pin Yue
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
General Anesthesia ◽  
Postoperative Nausea ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Antiemetic Drugs ◽  
Pacu Stay

OBJECTIVE Postoperative nausea and vomiting (PONV) is an extremely common side effect of general anesthesia that is difficult to manage. We tested a hypothesis that an aggressive prophylactic intervention with additional antiemetic drugs will reduce the incidence of PONV in a high-risk pediatric population undergoing adenotonsillectomy. METHODS In this retrospective study, pediatric patients undergoing adenotonsillectomy were screened for their risk factors for PONV. Patients who had 3 or more risk factors were identified as high risk and received either scopolamine patch preoperatively (for patients over 40 kg body weight) or diphenhydramine immediately postextubation in addition to ondansetron and dexamethasone, which are given routinely. Incidences of PONV within the first 60 minutes of a postanesthesia care unit (PACU) stay were collected and analyzed. RESULTS Overall postoperative vomiting rates during the first hour of a PACU stay were 4.3% for the group that was treated with dexamethasone and ondansetron only and 3.9% for the group that was treated with additional antiemetic drugs. Aggressive prophylactic management of PONV did reduce the rate of nausea and vomiting in a group of high-risk patients (p < 0.0001). The postoperative antiemetic drug usage was also decreased during the first 60 minutes of a PACU stay. However, the approach did not reduce the overall rate of PONV for the entire study population (p = 0.1612 for nausea and p = 0.0678 for vomiting). CONCLUSION Aggressive intraoperative management of PONV with additional antiemetic drugs are beneficial in high-risk pediatric population. Intraoperative diphenhydramine usage decreased the rate of PONV. However, preoperative scopolamine patch prevention did not improve PONV, which may be related to the drug's longer onset of action. Our result suggests that current clinical practice is undertreating PONV in pediatric patients receiving general anesthesia.

scholarly journals Gastric Decompression Decreases Postoperative Nausea and Vomiting in ENT Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Kerem Erkalp ◽  
Nuran Kalekoglu Erkalp ◽  
M. Salih Sevdi ◽  
A. Yasemin Korkut ◽  
Hacer Yeter ◽  
...  
Keyword(s):  
Stomach Content ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Ent Surgery ◽  
Group I ◽  
Significant Difference ◽  
Gastric Decompression ◽  
Group Ii ◽  
The Relationship

There is a passive blood flow to the stomach during oral and nasal surgery. It may cause postoperative nausea and vomiting (PONV). We researched the relationship between gastric decompression (GD) and severity of PONV in ear, nose, and throat (ENT) surgery. 137 patients who have been into ENT surgery were included in the study. In Group I (n=70), patients received GD after surgery before extubation; patients in Group II (n=67) did not receive GD. In postoperative 2nd, 4th, 8th, and 12th hours, the number and ratio of patients demonstrating PONV were detected to be significantly more in Group II as compared to Group I. PONV was also significantly more severe in Group II as compared to Group I. In Group I, the PONV ratio in the 2nd hour was significantly more for those whose amounts of stomach content aspired were more than 10 mL as compared to those whose stomach content aspired was less than 10 mL. In the 4th, 8th, and 24th hours, there is no statistically significant difference between the stomach content aspired and PONV ratio. GD reduces the incidence and severity of PONV in ENT surgery.

scholarly journals Dexamethasone is cost-effective alternative to ondansetron in preventing Post-Operative Nausea and Vomiting

2020 ◽  
Vol 24 (1) ◽  
pp. 14-21
Author(s):  
Muhammad Sazzad Hossain ◽  
Md Afzalur Rahman ◽  
Mamunur Rashid ◽  
Mahiuddin Alamgir ◽  
Md Waliullah ◽  
...  
Keyword(s):  
Placebo Group ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Cost Effective ◽  
Nausea And Vomiting ◽  
Dexamethasone Group ◽  
Ent Surgery ◽  
Cost Effective Alternative ◽  
Post Operative Nausea ◽  
Late Postoperative Period

Background: Postoperative nausea and vomiting (PONV) is a common complication of anesthesia and surgery. Numerous anti-emetics have been studied to prevent and treat PONV. Methods: This study evaluated the antiemetic efficacy, cost-effectiveness and clinical utility of prophylactic dexamethasone and ondansetron compared with placebo in prevention of postoperative nausea and vomiting after ENT surgery in 90 patients. Results: The incidence of PONV was significantly greater in placebo group than dexamethasone group and ondansetron group (p<0.05). The incidence in the dexamethasone group 10% and ondansetron group 26.66% were comparable p>0.05. The incidence of early (0-6 h) PONV was significantly lower in dexamethasone group and ondansetron group than the placebo group (p <0.05). The early incidence was comparable in the dexamethasone (10%) and ondansetrone (13.33%) group( p>0.05). The incidence of PONV in the late postoperative period (6-24 h) was significantly lower in the dexamethasone group (3.33%) than the ondansetron group (23.33%) P<0.05. Conclusion: Both dexamethasone and ondansetron were more effective than placebo in preventing postoperative nausea and vomiting after ENT surgery but dexamethasone was more effective, less expensive and safer than ondansetron, therefore, it may be better substitute for ondansetron. Bangladesh J Otorhinolaryngol; April 2018; 24(1): 14-21

scholarly journals Comparison of ondansetron used alone and in combination with dexamethasone as a prophylaxis for postoperative nausea and vomiting following laparoscopic cholecystectomy

2015 ◽  
Vol 9 (1) ◽  
pp. 3-6
Author(s):  
Lipika Sanjowal ◽  
Swapan Kumar Biswas ◽  
Jitesh Chandra Saha
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Complete Response ◽  
Nausea And Vomiting ◽  
Antiemetic Prophylaxis ◽  
Group I ◽  
Elective Laparoscopic Cholecystectomy ◽  
Group Ii ◽  
Induction Of Anaesthesia

Postoperative nausea and vomiting (PONV) is common after anaesthesia and surgery. In patients undergoing laparoscopic cholecystectomy (LC) without antiemetic prophylaxis, the incidence can be as high as 76% which would cause unexpected delay in hospital discharge. This study was designed to compare the efficacy of the ondansetron alone with combination of ondansetron and dexamethasone the given as prophylaxis for PONV in patients undergoing laparoscopic cholecystectomy. One hundred patients undergoing elective laparoscopic cholecystectomy were selected and randomly divided into 2 groups of 50 each. Group I received 4mg of ondansetron intravenously (iv), whereas Group II received ondansetron 4mg and dexamethasone 4mg just before induction of anaesthesia. Postoperatively, the patients were assessed for episodes of nausea, vomiting and need for rescue antiemetic. Complete response defined as no nausea and vomiting during first 24 hours, was noted in 76% of patients in Group I and in 92% of patients in Group II. Rescue anti emetic requirement was less in Group II (4%) than Group I (20%). So it can be concluded that the combination of ondansetron and dexamethasone is more effective in preventing PONV in patients undergoing laparoscopic cholecystectomy than ondansetron alone.Faridpur Med. Coll. J. 2014;9(1): 3-6

scholarly journals Perbandingan antara ondansetron 4 mg iv dan deksametason 5 mg iv dalam mencegah mual-muntah pada pasien laparotomi dengan anestesia umum

e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Sitti I. Yanhil ◽  
Barry I. Kambey ◽  
Harold F. Tambajong
Keyword(s):  
General Anesthesia ◽  
Postoperative Nausea ◽  
Random Sampling ◽  
Analytical Study ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Treatment Groups ◽  
Drug Of Choice ◽  
Dexamethasone Group ◽  
Significant Difference

Abstract: Nausea and vomiting are the most frequent side effects which occur postoperatively as a result of general anesthesia. Postoperative nausea and vomiting may increase morbidity and extend the duration of patient to stay at the recovery room. Ondansetron drug that has the effect as 5-HT3 antagonist receptor and dexamethasone administration might be the drug of choice in preventing postoperative nausea and vomiting. This study was aimed to compare the effect of 4 mg ondansetron and 5 mg dexamethasone administration on the incidence of postoperative nausea and vomiting in laparotomy surgery with general anesthesia. This was a prospective analytical study with an experimental method. Samples were obtained by using consecutive random sampling. There were 32 patients aged 18 to 60 years old, ASA I-II clasification, divided into two treatment groups as follows: ondansetron group given at the end of operation and dexamethasone group given before the induction of anesthesia. The resultas showed that complaints of postoperative nausea and vomiting mostly occured at the 5 mg dexamethasone group (37.5%) rather than 4 mg ondansetron group (12.5%). The Mann-Whitney test showed that there were no significant difference between both groups (p>0.05). Conclusion: Administration of 4 mg ondansetron intravenously has the same effectivity as 5 mg dexamethasone intravenously in reducing the incidence of postoperative nausea and vomiting after laparotomy with general anesthesia. Keywords: nausea and vomiting, ondansetron, dexamethasone Abstrak: Mual-muntah merupakan efek samping yang paling sering didapatkan pasca operasi akibat pemberian anestesia umum. Mual-muntah pasca operasi dapat meningkatkan morbiditas dan memperpanjang masa rawat pasien dari ruang pulih. Pemberian obat ondansetron yang berefek 5-HT3 reseptor dan deksametason dapat menjadi obat pilihan dalam mencegah terjadinya mual muntah pascaoperasi. Penelitian ini bertujuan untuk membandingkan pemberian ondanetron 4 mg dan deksametason 5 mg terhadap kejadian mual-muntah pasca operasi pada bedah laparotomi dengan anestesia umum. Jenis penelitian ialah analitik prospektif dengan metode eksperimental. Sampel didapatkan secara consecutive random sampling yang dilakukan pada 32 pasien dengan rentang usia 18-60 tahun, klasifikasi ASA I-II, yang dibagi menjadi dua kelompok perlakuan: kelompok ondansetron yang diberikan di akhir operasi dan kelompok deksametason sebelum induksi anestesia. Hasil penelitian mendapatkan keluhan mual muntah pascaoperasi lebih banyak terjadi pada kelompok deksametason 5 mg (37,5%) dibandingkan kelompok ondansetron 4 mg (12,5%). Uji Mann-Whitney mendapatkan tidak ada perbedaan bermakna antara keduanya (p >0,05). Simpulan: Pemberian ondansetron 4 mg intravena memiliki efektivitas yang sama dengan deksametson 5 mg iv dalam menurunkan kejadian mual-muntah pasca operasi laparotomi dengan anestesia umum.Kata kunci: mual muntah, ondansetron, deksametason

Amisulpride Prevents Postoperative Nausea and Vomiting in Patients at High Risk

2018 ◽  
Vol 128 (6) ◽  
pp. 1099-1106 ◽  
Author(s):  
Peter Kranke ◽  
Sergio D. Bergese ◽  
Harold S. Minkowitz ◽  
Timothy I. Melson ◽  
David G. Leiman ◽  
...  
Keyword(s):  
High Risk ◽  
General Anesthesia ◽  
Postoperative Nausea ◽  
Rescue Medication ◽  
Elective Surgery ◽  
Medication Use ◽  
Postoperative Nausea And Vomiting ◽  
Complete Response ◽  
Nausea And Vomiting ◽  
Control Group

Abstract Background Postoperative nausea and vomiting causes distress for patients and can prolong care requirements. Consensus guidelines recommend use of multiple antiemetics from different mechanistic classes as prophylaxis in patients at high risk of postoperative nausea and vomiting. The prophylactic efficacy of the dopamine D2/D3 antagonist amisulpride in combination with other antiemetics was investigated. Methods This double-blind, randomized, placebo-controlled, international, multicenter trial was conducted in 1,147 adult surgical patients having three or four postoperative nausea and vomiting risk factors. Patients were randomized to receive either intravenous amisulpride (5 mg) or matching placebo at induction of general anesthesia, in addition to one standard, nondopaminergic antiemetic, most commonly ondansetron or dexamethasone. Vomiting/retching, nausea, and use of rescue medication were recorded for 24 h after wound closure. The primary endpoint was complete response, defined as no emesis or rescue medication use in the 24-h postoperative period. Results Complete response occurred in 330 of 572 (57.7%) of the amisulpride group and 268 of 575 (46.6%) of the control group (difference 11.1 percentage points; 95% CI, 5.3 to 16.8; P &lt; 0.001). The incidences of emesis (13.8% vs. 20.0%, P = 0.003), any nausea (50.0% vs. 58.3%, P = 0.002), significant nausea (37.1% vs. 47.7%, P &lt; 0.001), and rescue medication use (40.9% vs. 49.4%, P = 0.002) were significantly lower in the amisulpride group. Adverse events and laboratory and electrocardiogram abnormalities occurred no more frequently with amisulpride than with placebo. Conclusions Intravenous amisulpride was safe and effective as prophylaxis of postoperative nausea and vomiting when given in combination with an antiemetic from another class to adult patients at high risk for suffering postoperative nausea and vomiting undergoing elective surgery under inhalational general anesthesia.

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

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