Comparative study of ondansetron, granisetron and granisetron with dexamethasone for prevention of postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy

Abstract

An assortment of drugs are being used for managing postoperative nausea and vomiting after laparoscopic surgeries. Combination anti-emetic therapy using 5HT3 antagonists with dexamethasone as an adjunct is being tried owing to its improved efficacy for prevention or treatment of PONV. This was a prospective, randomized, double blind, comparative study conducted on 150 patients aged between 18 to 65 years scheduled for laparoscopic cholecystectomy. Group O received 0.1 mg/Kg IV ondansetron upto a maximum dose of 8 mg, Group G received 0.04 mg/kg IV granisetron upto a maximum dose of 3mg, Group G+D will receive 0.04mg/kg IV granisetron and 8mg Dexamethasone. The three groups were comparable in terms of demographic data. Our results showed that the patients who had received combination of granisetron and Dexamethasone showed a better complete response as compared to patients who received ondansetron and patients who received granisetron alone. This was seen in all three time periods of 2-6 hours, 6-12 hours and 12-24 hours postoperatively with a p value less than 0.001 making it statistically significant. : Combination therapy with granisetron and dexamethasone IV used as prophylactic antiemetic is better than granisetron or ondansetron given IV alone. IV granisetron and dexamethasone combination has fewer side effects compared to ondansetron or granisetron. Need for the rescue antiemetic was least in the patients receiving granisetron and dexamethasone combination as compared to in patient receiving ondansetron and granisetron alone.