Postoperative nausea and vomiting prophylaxis: A comparative study of ondansetron, granisetron and granisetron and dexamethasone combination after modified radical mastectomy

Gupta, Pushplata; Jain, Shilpi

doi:10.4103/1658-354x.144081

Cited by 14 publications

(3 citation statements)

References 19 publications

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“…21 Anti-emetics are very important for preventing post-operative nausea and vomiting especially in cases where general anesthesia is administered. 22 In most of the other studies, anti anxiety drugs were most commonly used, like study done by Venkitachalam et al in 2018, where midazolam was used in 100% of cases. 21 However, as per study done by Kulkarni et al in 2017, only 10.9% received anti-anxiety drugs and that too midazolam was most commonly used similar to our study.…”

Section: Discussionmentioning

confidence: 99%

Pattern of Pre-Anesthetic Medications Used In Various Surgical Specialties in A Tertiary Care Hospital

Pradhan,

Maharjan,

Lamichhane

et al. 2024

J. KIST Med. Col

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Introduction: Most of the surgeries done in our country under anesthesia are mostly at urban region and very low number at remote areas. Even those surgeries done under anesthesia do not receive proper premedication. Pre-anesthetic medicine has been linked to a variety of outcomes, including postoperative recovery time, the need for postoperative analgesia, and hospital stay. Yet, we have very less data regarding the patterns of use of drugs for premedication. Methods: It is a cross-sectional descriptive study performed in the department of Anesthesiology at KIST Medical College and Teaching Hospital from 15th Feb 2022 till 14th Feb 2023, after obtaining ethical clearance from the Institutional Review Committee. The total sample size was 385 which were calculated using Cochrane formula. All the patients who belonged to American Society of Anesthesiologists (ASA) I-III undergoing elective surgical procedures and administered premedication were selected for the study only after their informed written consent. Results: Out of 496 cases, 385 (53.8%) of patients were selected and pre-medications were recorded. The premedication used were metoclopramide 375 (97.4%), pantoprazole 375 (97.4%), paracetamol 52 (13.5%), glycopyrrolate 26 (6.75%), pregabalin 21 (5.45%), alprazolam 20 (5.19%), and lorazepam 1 (0.25%). Types of surgeries categorizations were 59.22 % general surgery, 17.92 % Gynecological and Obstetrics, 17.14 % Orthopedic cases, 4.67 % ENT and 1.04 % dental cases. Conclusion: The most commonly administered pre-anesthetic drugs were metoclopramide, pantoprazole, paracetamol, pregabalin, alprazolam and then lorazepam.

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Section: Discussionmentioning

confidence: 99%

Pattern of Pre-Anesthetic Medications Used In Various Surgical Specialties in A Tertiary Care Hospital

Pradhan,

Maharjan,

Lamichhane

et al. 2024

J. KIST Med. Col

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“…Different doses of drugs are one of the major reasons for variable results, as Riad and Marouf [ 15 ] have used granisetron at a dose of 10 mcg/kg and dexamethasone at 500 mcg/kg after pediatric strabismus surgery which is different from the doses used in the present study (granisetron at 40 mcg/kg and dexamethasone at 150 mcg/kg). Gupta and Jain used granisetron at a dose of 40 mcg/kg for PONV prophylaxis after breast cancer surgery [ 16 ]. Dexamethasone has also been used at different doses (50 mcg/kg–1 mg/kg) for PONV prophylaxis and variable results were found [ 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

Granisetron versus Granisetron-Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Pediatric Strabismus Surgery: A Randomized Double-Blind Trial

Saxena

Shende

Maitra

et al. 2016

Anesthesiology Research and Practice

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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 was CTRI/2009/091/001000.

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“…Postoperative nausea and vomiting is one of the most distressing experiences associated with surgery 1 and is known to be the second most common complaint in the postoperative period after pain. 2 The incidence of postoperative nausea and vomiting without any prophylaxis ranges from 20-30% 2 which increases to 41-88.0% in high risk surgeries like strabismus, 3 laparoscopic, 4 breast 5 and middle ear surgery.…”

Section: Introductionmentioning

confidence: 99%

Combination of Granisetron and Dexamethasone for prevention of postoperative nausea and vomiting following laparoscopic cholecystectomy

Joshi

Prasai

2023

Nep. Med. Coll. J.

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Postoperative nausea and vomiting (PONV) is the second most common complaint in postoperative period especially in high risk surgeries like laparoscopic cholelithiasis. Many pharmacological strategies has been used for its prevention as PONV may cause adverse effects. Drugs like granisetron and dexamethasone has been used alone and in combination for the prophylaxis of PONV. We observed the adequacy and safety of the combination of these drugs by injecting granisetron (40mcg/kg) with dexamethasone (6mg) after induction of anesthesia. The total number of cases enrolled was 115. During 0-2 hours postoperatively, nausea, retching or vomiting was not seen in 110 (95.7%) of patients. Four (3.5%) patients had nausea or retching and 1 (0.9%) had vomiting episode in 30 minutes duration. During 2-6 hours, no nausea, retching or vomiting was seen in 113 (98.3%) patients and an episode of nausea was present in 2 (1.7%) cases. There was no nausea, retching or vomiting in any patient during 6-12 and 12-24 hours. The prophylactic anti-emetic therapy with combination of granisetron and dexamethasone is effective and safe during the first 24 hours in the postoperative period after laparoscopic cholecystectomy.

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Postoperative nausea and vomiting prophylaxis: A comparative study of ondansetron, granisetron and granisetron and dexamethasone combination after modified radical mastectomy

Cited by 14 publications

References 19 publications

Pattern of Pre-Anesthetic Medications Used In Various Surgical Specialties in A Tertiary Care Hospital

Pattern of Pre-Anesthetic Medications Used In Various Surgical Specialties in A Tertiary Care Hospital

Granisetron versus Granisetron-Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Pediatric Strabismus Surgery: A Randomized Double-Blind Trial

Combination of Granisetron and Dexamethasone for prevention of postoperative nausea and vomiting following laparoscopic cholecystectomy

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