Comparison of intravenous Ondansetron and Granisetron in prevention of Post Cesarean section operation Nausea and Vomiting in 22Bahman Hospital of Mashhad Islamic Azad university
Subject Areas : علوم پزشکیHamed Beyzai 1 , yasamanhozhabr hozhabrosadat 2 , Vahid Maghferati 3 , Mozhgan Raisi 4
1 -
2 -
3 -
4 -
Keywords: Ondansetron, Granisetron, Nausea, Vomiting,
Abstract :
Background: Postoperative nausea and vomiting is caused by various factors and based on studies comparing the effects of various drugs in the prevention of postoperative nausea and vomiting. Purpose: To compare the effectiveness of intravenous Ondansetron and Granisetron in the prevention of nausea and vomiting after cesarean section in spinal anesthesia procedures. Method: We randomly assigned the women to cesarean surgery under spinal anesthesia in a 22 Bahman Hospital Islamic Azad University of Mashhad, and patients were divided into two groups of each 84 person, Group I, intravenously ondansetron 4 mg and Group II, Granisetron 1 mg intravenously before anesthesia received, and questionnaire data on nausea and vomiting during the first hour after anesthesia records, we collected and analyzed. Results: In our study 84 cases in the ondansetron group, 21 patients (25%) were had nausea and in Granistron group, 7 patients (8.3%) were had nausea. (P-value=0.004) The incidence of vomiting in the ondansetron group, 7 of 84 patients (8.3%) and vomiting was no reported in Granisetron group. (P-value=0.014) Our findings suggest that 1mg Granisetron intravenously before spinal anesthesia is more effective than 4mg Ondansetron intravenously in the prevention of nausea and vomiting after cesarean section. Discussion: Our findings support the effectiveness of Granisetron than Ondansetron. And recommended further studies to evaluate the effect of drug combination compared with either drug alone for the prevention of postoperative nausea and vomiting is performed in the future.
1.Ronald D Miller.Postoperative nausea and vomiting.In:Ronald D Miller.Miller’s Anesthesia.7th ed.Philadelphia:Churchill Livingstone;2010.2729-2757.
2.Lee PJ, Pandit SK, Green CR.Postaneshthetic effects in the outpatient: Which most important.Anesth Analg.2005 Nov;79(2):71-75.
3.Watcha MF, White PF.Postoperative nausea and vomiting treatment and prevention.Anesthesiology.2002 Oct;77(3):162-168.
4.Hardmas JG, Limberd LE.Goodman and Gilman’s pharmacologic basis of therapeutics.9th ed.New York:MC Graw Hill;2000.857-894.
5.Metter SE.Nausea and vomiting after outpatient laparascopy:incidence,impact on recovery room stay and cost.Anesth Analg.2005 Nov;66(3):116-120.
6.Guyton AC.Textbook of Medical physiology.9th ed.New York:Saunders company;2000.1056-1109.
7.Toner CC.Prediction of postoperative nausea and vomiting a logistic regression Model.Br J Anesth.2000 May;76(4):347-351.
8.Lerman J.Surgical and patient factors involved in postoperative nausea and vomiting.Br J Anesth.2004 Jan;69(5):524-533.
9.Sinclair DR.Can postoperative nausea and vomiting be predicted.Anesthesiology.2004 Feb;91(6):109-116.
10.Patel RI.Anesthetic complications following pediatric ambulatory surgery.Anesthesiology.2008 Apr;69(8):1009-21.
11.Okum GS.Vomiting after alfenatil anesthesia:effect of dosing method.Anesth Analg.2004 May;75(3):558-560.
12.Collins KM.Postoperative morbidity following gynecologic outpatient laparoscopy.A reappraisal of the service Anesthesia.2000 Dec;39(5):819-821.
13.Larson S.A prospective survey of postoperative nausea and vomiting with special regard to incidence and relations to patient characteristics,anaesthetic routines and surgical procedures.Acta Anasthesiol Scand.2005 May;39(3):539-45.
14.Schecter NL.The use of oral transmucosal fentanyl citrate for painful procedures in children.Pediatrics.2000 Jul;95(5):335-342.
15.Epstein RH.The safety and efficacy of oral transmucosal fentanyl citrate for preoperative sedation in young children.Anesth analg.2006 Nov;83(6):1200-11.
16.Hobbhahn J, Funk W.Sevoflurane in pediatric anesthesia.Anesthesia.2000 Feb;45(4):22-35.
17.Raftery S, Sherry E.Total intravenous anesthesia with propofol and alfentanil protects against nausea and vomiting.Can J Anesth.2008 Jul;39(3):37-42.
18.Chittleborough MC.Double blind comparison of patient recovery after induction with propofol or thiopentone for day case relaxant general anesthesia.Anesth Intensive care.2002 Nov;20(4):169-80.
19.Harris AL.Cytotoxic therapy induced vomiting in mediated via enkephaline pathways.Lancet.2000 May;1(1):714-20.
20.Bonica JJ.Managment of pain.2th ed.Philadelphia:lea and Febiger;2000.
21.Lauretti GR.Intrathecal neostigmine for postoperative analgesia after orthopedic surjery.J Clin Anesth.2004 Nov;9(3):473-83.
22.Carpenter RL, Caplan RA, Brown DL.Incidence and risk factor for side effects of spinal anesthesia.Anesthesiology.2004 May;76(4):906-16.
23.Comroe JH, Dripps RD.Reactions to morphine in ambulatory patients.Surg Gynecol Obstet.2008 Jan;87(6):221-30.
24.Schreiner MS.Should children drink before discharge from day surgery.Anesthesiology.2004 Feb;76(3):528-32.
25.Wanger BK.Retrospective analysis of postoperative nausea and vomiting to determine antiemitec activity of droperidol added to propofol.Pharmacotherapy.2004 May;14(5):586-92.
26.Venter DF.Dimenhydrinate decreases vomiting after strabismus surgery in children.Anesth Analg.2006 Apr;82(3):728-35.
27.Naylor RJ, Inall FC.The physiology and pharmacology of postoperative nausea and vomiting.Anesthesia.2004 Jun;49(2):2-11.
28.Splinter WM, Roberts DJ.Dexamethasone decreases vomiting by children after tonsillectomy.Anesth Analg.2000 May;83(4):913-23.
29.Arfeen Z, Owen H.A double blind randomized controlled trial of ginger for the prevention of postoperative nausea and vomiting.Anaesth Int Care.1995 Apr;23(2):449-52.
30.Lopez L, Carrascosa F.Combination of ondansetron and dexamethasone in the prophylaxis of postoperative nausea and vomiting.Br J Anesth.2004 Feb;76(2):835-42.
31.Al sadi M, Newman B.Acupuncture in the prevention of postoperative nausea and vomiting.Anesthesia.2006 May;52(6):658-64.
32.Cook JA, Murrant NS, Evans KL.A randomized comparison of three posttonsillectomy diets.Clin Otolaryngol.1992 Mar;17(2):28-34.
33.Gan TJ, Coop A, Philip BK.A randomized, double-blind study of granisetron plus dexamethasone versus ondansetron plus dexamethasone to prevent postoperative nausea and vomiting in patients undergoing abdominal hysterectomy.Anesth Analg.2005 Nov;101(5):1323-9.
34.Jain V, Mitra JK, Rath GP, Prabhakar H, Bithal PK, Dash HH.A randomized, double-blinded comparison of ondansetron, granisetron, and placebo for prevention of postoperative nausea and vomiting after supratentorial craniotomy.J Neurosurg Anesthesiol.2009 Jul;21(3):226-30.
35.Metaxari M, Papaioannou A, Petrou A, Chatzimichali A, Pharmakalidou E, Askitopoulou H.Antiemetic prophylaxis in thyroid surgery: a randomized, double-blind comparison of three 5-HT3 agents.J Anesth.2011 Jun;25(3):356-62.
36.Erhan Y, Erhan E, Aydede H, Yumus O, Yentur A.Ondansetron, granisetron, and dexamethasone compared for the prevention of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy : A randomized placebo-controlled study.Surg Endosc.2008 Jun;22(6):1487-92.
37.Bhatnagar S, Gupta D, Mishra S, Srikanti M, Singh M, Arora R.Preemptive antiemesis in patients undergoing modified radical mastectomy: oral granisetron versus oral ondansetron in a double-blind, randomized, controlled study.J Clin Anesth.2007 Nov;19(7):512-6.
38.Quan X, Ye TH, Zhu B.A randomized double-blind study of prevention of postoperative nausea and vomiting with ondansetron, tropisetron, or granisetron in patients undergoing general anesthesia.Zhongguo Yi Xue Ke Xue Yuan Xue Bao.2007 Feb;29(1):107-10.
39.Tang DH, Malone DC.A network meta-analysis on the efficacy of serotonin type 3 receptor antagonists used in adults during the first 24 hours for postoperative nausea and vomiting prophylaxis.Clin Ther.2012 Feb;34(2):282-94.
40.Quan X, Zhu B, Ye TH.Preventive efficacy of ondansetron and granisetron for postoperative nausea and vomiting in high risk patients.Zhongguo Yi Xue Ke Xue Yuan Xue Bao.2011 Aug;33(4):445-8.
41.Basu A, Saha D, Hembrom BP, Roy A, Naaz A.Comparison of palanosetron, granisetron and ondansetron as anti-emetics for prevention of postoperative nausea and vomiting in patients undergoing middle ear surgery.J Indian Med Assoc.2011 May;109(5):327-9.
42.Oksuz H, Zencirci B, Ezberci M.Comparison of the effectiveness of metoclopramide, ondansetron, and granisetron on the prevention of nausea and vomiting after laparoscopic cholecystectomy.J Laparoendosc Adv Surg Tech A.2007 Dec;17(6):803-8.
43.Wu SJ, Xiong XZ, Lin YX, Cheng NS.Comparison of the efficacy of ondansetron and granisetron to prevent postoperative nausea and vomiting after laparoscopic cholecystectomy: a systematic review and meta-analysis.Surg Laparosc Endosc Percutan Tech.2013 Feb;23(1):79-87.
44.Fujii Y.The benefits and risks of different therapies in preventing postoperative nausea and vomiting in patients undergoing thyroid surgery.Curr Drug Saf.2008 Jan;3(1):27-34.
45.Dua N, Bhatnagar S, Mishra S, Singhal AK.Granisetron and ondansetron for prevention of nausea and vomiting in patients undergoing modified radical mastectomy.Anaesth Intensive Care.2004 Dec;32(6):761-4.
46.Riad W, Marouf H.Combination therapy in the prevention of PONV after strabismus surgery in children: granisetron, ondansetron, midazolam with dexamethasone.Middle East J Anesthesiol.2009 Oct;20(3):431-6.
47.Fujii Y.Prevention of emetic episodes during cesarean delivery performed under regional anesthesia in parturients.Curr Drug Saf.2007 Jan;2(1):25-32.
48.Ben Gibbison, Ruth Spencer. Post-operative nausea and vomiting. Anaesthesia & intensive care medicine. 2009 Dec;12(10):583-585.
49.S.I.Kim, S.C.Kim, Y.H.Baek, S.Y.Ok, S.H.Kim. Comparison of ramosetron with ondansetron for prevention of postoperative nausea and vomiting in patients undergoing gynaecological surgery. Department of anesthesiology and pain medicine,Seoul 2006; 71 : 255-258.
50.Dr.Mohd. Parvez Khan. Prophylactic antiemetic therapy using combinations of granisetron,dexamethasone and droperidol in patients undergoing laparoscopic cholecystectomy.Anaesthesia 2009 Jul;83(5):186-194.
51.Jain, Virendra MD, Jayanta K.MD, Hemanshu MD . A randomized,double-blinded comparison of ondansetron, granisetron, and placebo for prevention of postoperative nausea and vomiting after supratentorial craniotomy. Journal of neurosurgical anesthesiology.2009;21(3):226-230.
52. Dolin SJ, Cashman JN, Bland JM.Effectiveness of acute postoperative pain management. I Evidence from published data.Br J Anaesth.2002 Dec;89(2):409-423.
53.Palazzo , Evans R.Logistic regression analysis of fixed patient factors for postoperative sickness. A model for risk assessment.Br J Anaesth.1993 Jun; 70(3):135-140.
54.Stadler M, Bardiau F, seidel I.Difference in risk factors for postoperative nausea and vomiting.Anesthesiology.2003 Nov; 98(4):46-52.
55.Koiruranta M, laara E, snare L, Alabuhta S. A survey of postoperative nausea and vomiting.Anesthesia.1997Jun;52(2):443-449.
56. Apfel CC,laara E, Koivuranta M . A simplified risk score for predicting postoperative nasea and vomiting. Conclusions form cross-validations between two centers. Anesthesiology. 1999Feb;91(2):693-700.
57. Macario A, weinger M, carney S, Kim A. which clinical anesthesia outcomes are important to avoid? The perspective of patients. Anesth Analg.1999 May;89(3):652-658.
58. Darkow T, Gora-Harper MI, Goulson DT, Record KE.Impact of antiemetic selection on postoperative nausea and vomiting and patient satisfaction. Pharmacotherapy. 2001 Dec;21(2):450-548.
_||_
