Evaluation of granisetron as an antiemetic in patients undergoing abdominal hysterectomy under spinal anaesthesia

Authors

  • Siddharth Uttam Nikam Department of Pharmacology, Government Medical College, Aurangabad, Maharashtra, India
  • Prakash N. Khandelwal Department of Pharmacology, Government Medical College, Aurangabad, Maharashtra, India
  • Ujwala B. Gawali Department of Pharmacology, Government Medical College, Aurangabad, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20170995

Keywords:

Granisetron, IONV, Ondansetron, PONV

Abstract

Background: PONV most common complications related to surgery and anaesthesia despite major advances in spinal, epidural and combined spinal-epidural anesthesia techniques IONV are still present in a significant number of patients. Ondansetron, used for controlling PONV induced by chemotherapy or radiation. Recently 5HT3 receptor antagonist granisetron has more potent, selective and longer acting activity than ondansetron. Granisetron is more active for control of PONV in cisplatin induced vomiting than ondansetron. It also reduces PONV in strabismus repair, tonsillectomy, and general surgeries, it has less side effects as compared to ondansetron. Objective of the study was to study efficacy and safety of granisetron and compare it with ondansetron for prevention of IONV and PONV.

Methods: 80 ASA grade I and II women undergoing abdominal hysterectomy under spinal anaesthesia were studied. Patients in group A received injection granisetron 2 mg and group B injection ondansetron 4 mg,10 minutes prior to induction of spinal anaesthesia. Main outcome measures were occurrence of nausea, retching or vomiting in intraoperative and postoperative period at 6, 12, 18 and 24 hours’ post-surgery. The response of patient to therapy and side effects were evaluated in both groups. The results were analyzed by ‘z’ test (p<0.5) considered significant.

Results: Demographic characteristics of both groups were comparable patients in granisetron (80%) had more complete response as compared to ondansetron (47.5%). Adverse effects were lower in granisetron group.

Conclusions: Granisetron 2 Mg has better efficacy and safety profile than ondansetron 4 Mg.

Metrics

Metrics Loading ...

Author Biography

Siddharth Uttam Nikam, Department of Pharmacology, Government Medical College, Aurangabad, Maharashtra, India

Dept of pharmacology,assistant professor,govt medical college,aurangabad.  Home address- nagsen colony,shantinagar,ulhasnagar,thane-421003,maharashtra.

References

Watcha MF. Post-operative nausea and vomiting. Anesthesiology. 1992;77(1):162-84.

Uddin MR, Aziz L. Comparison of ondansetron and granisetron for prevention of PONV following elective LUCS. J BSA. 2007;20:61-6.

Ommid M, Ahmad M. Comparative evaluation of ondansetron and granisetron in prevention of postoperative nausea and vomiting following laparoscopic cholecystectomy in females. IOSR. 2013;4:15-20.

Lerman J. Surgical and patient factors involved in postoperative nausea and vomiting. Br J Anaesth. 1992;69:245-325.

Mandira D, Biswas BN, Suman CR, Omized. Placebo-controlled trial of granisetron for Control of nausea and vomiting during cesarean delivery under spinal anaesthesia. J ObsGyne Ind. 2012;62(4):419-23.

Yogendran S, Sunthera LY. A prospective randomized double blinded study of the effect of intravenous fluid therapy on adverse outcomes on outpatient surgery. Anesthesia& Analgesia. 1995;80(4):682-6.

Borgeat A, Ekatodramis G, Schenker CA. Postoperative nausea and vomiting in regional anesthesia. Anesthesiology. 2003;98:530-47.

Balki M, Carvalho JC. Intraoperative nausea and vomiting during caesarean section under regional anaesthesia. Int J Obstet Anaesth. 2005;14(3):230-41.

Gupta V, Wakhloo R, Mehta A, Gupta SD. Prophylactic antiemetic therapy with ondansetron, granisetron and metoclopramide in patients undergoing laparoscopic cholecystectomy under GA. JK Science. 2008;10(2):74-7.

Wang JJ, Ho TS, Liu SH, Ho M C. Prophylactic anti emetic effect of dexamethasone in women undergoing ambulatory laparoscopic surgery. Br J Anaesth 2000; 84(4):459-62.

Paxton DL, Mekay CA, Mirakin KR. Prevention of nausea and vomiting after day case gynaecological laparoscopy. Anaesthesia. 1995;50:403-6.

Cubeddu LX, Hoffmann IS, Fuenmayor NT, Finn AL. Efficacy of ondansetron (GR38032F) and the role of serotonin in cisplatin-induced nausea and vomiting. New Eng J Med. 1990;322(12):810-6.

Pan AK, Rudra A. Prophylactic single dose intravenous administration of ondansetron in the prevention of postoperative emetic symptoms during spinal anaesthesia for caesarean delivery. Indian J. Anaesth. 2003;47(3):178-80.

Garcia-Miguel FJ, Montano E, Martin-Vicente V, Fuentes AL, Alsina FJ, San Jose JA. Prophylaxis against intraoperative nausea and vomiting during spinal anaesthesia for caesarean section: A comparative study of ondansetron versus metoclopramide. Journal Anaesthes 2000;4(2).

Fujii Y, Tanaka H, Toyooka H. Effective dose of granisetronfor preventing postoperative emesis in children. Can J Anaesth. 1994;43:35-8.

Janknegt R. Double-blind comparative study of droperidol, granisetron and granisetron plus dexamethasone as prophylactic antiemetic therapy in patients undergoing abdominal, gynaecological, breast or otolaryngological surgery. Anaesthesia. 1999;54(11):1059-68.

Bhattacharya D, Banerjee A, Comparison of ondansetron and granisetron for prevention of nausea and vomiting following day care gynaecological laparoscopy, Indian J Anaesh. 2003;47(4):279-82.

Lwanga SK, Lemeshow S, editors. Sample size determination in health studies: A practical manual. Geneva. Switzerland: World Health Organisation. 1991.

Kovac AL. Meta-Analysis of the use of rescue antiemetics following PONV prophylactic failure with 5-HT3 antagonist/dexamethasone versus single-agent therapies. Annals of pharmacotherapy. 2006;40(5):873-87.

Mantovani G, Maccio A. A Comparison of Granisetron,Ondansetron and Tropisetron In the prophylaxix of acute nausea and vomiting induced by cisplatin for the treatment of Head and neck cancer. Cancer. 1996;77(5):941-8.

Chaudhari SA, Walande SS, Sirsat VS. A comparative study between ondansetron and granisetron preoperatively for prevention of PONV in elective LSCS under spinal anaesthesia. Inter J Pharma and therapeutics. 2014;4(3):10-20.

Kapur PA. The big “little problem”. Anesth analg. 1991;73:243-5.

Chidambaram A, Bylappa K, Somasekaram P. A Comparative Study Of Ondansetron And Granisetron For Prevention Of Nausea And Vomiting Following Laparoscopic Surgeries. The Inter J Anesthe. 2010;29 (1):1-12.

Wadaskar A, Swarnkar N. Granisetron has superior control over postoperative nausea and vomiting than ondansetron in gynecological surgeries: a placebo controlled double-blind clinical study. Internet J Anesthes. 2008;20(1)1-12.

Balki M, Kadoskar S. The prophylactic granisetron does not prevent postdelivery nausea and vomiting during elective caesarean delivery under spinal anaesthesia. Anasth analg. 2007;104:679-83.

Peter H, Moore CH. Comparing the efficacy of prophylactic metoclopramide, ondansetron and placebo in caesarean section patients given epidural anaesthesia. J clin anaesth. 2001;13:430-5.

Dua N, Bhatnagar S. Granisetron and Ondansetron for prevention of postoperative nausea and vomiting in patients undergoing modified radical mastectomy. Anaesth Intensive Care. 2004;32:761-4.

Downloads

Published

2017-03-28

How to Cite

Nikam, S. U., Khandelwal, P. N., & Gawali, U. B. (2017). Evaluation of granisetron as an antiemetic in patients undergoing abdominal hysterectomy under spinal anaesthesia. International Journal of Research in Medical Sciences, 5(4), 1331–1338. https://doi.org/10.18203/2320-6012.ijrms20170995

Issue

Section

Original Research Articles