N. Jagadeesh Babu, Ch. Penchalaiah
BACKGROUND: The most common and distressing symptoms that follow anaesthesia and surgery are pain and vomiting problems. Pain causes greater amount of suffering, but in some instances nausea and vomiting may be more distressing, particularly after minor surgery. Spinal anaesthesia has been shown to be easy, rapid and safe technique for caesarean section. Nevertheless, it has some minor side effects, including nausea and vomiting in more than 66% of the cases. (Ref (Chestnut D) H 1987). The abrupt diaphragmatic contractions, and protrusion of the abdominal viscera causes surgery more difficult, aspiration is a hazard. Hence we intended to compare the preventive and therapeutic effects of Granisetron and Ondansetron on the incidence of postoperative nausea and vomiting (PONV) in patients undergoing elective Lower segment caesarian section under spinal anaesthesia. OBJECTIVES: Post-operative nausea and vomiting (PONV) are commonly reported adverse events after surgery and can contribute to the development of aspiration, wound dehiscence, and increased bleeding. Prophylaxis with antiemetic has been shown to reduce the incidence of PONV as well as improve patient satisfaction. The main aim of this study is to compare the efficacy and safety of Granisetron with that of Ondansetron and placebo in the prevention of post-operative nausea and vomiting in patients undergoing lower segment caesarian section under spinal anaesthesia. This study is also intended to know the incidence of postoperative nausea and vomiting in this group of patients. Incidence of adverse effects of ondansetron and granisetron were also noted in this study. METHODS: With prior approval from the Institutional ethical committee and written informed consent, 75 patients of ASA grade I, aged between 20–30 years, body weight ranging from 45kg to 65 kg were studied. All the patients were subjected to elective caesarian section. RESULTS: We have studied 75 patients of ASA grade I, they were divided into three groups. 25 patients (group–P) received 10ml inj. Normal saline I.V, 25 patients (group–O) received inj. Ondansetron 4 mg diluted in 10ml normal saline I.V & 25 patients (group-G) inj. Granisetron 1mg I.V diluted in 10 ml normal saline. These drugs were administered 10 minutes before the administration of spinal anaesthesia. There were no significant differences between the three groups regarding patient characteristics (age, body weight, height and previous history of motion sickness and PONV), type of surgery, type of anaesthesia, and duration of pre-operative starvation, duration of surgery and administration of post-operative analgesics. Patient data were analysed by chi-square test and standard error or difference between proportions. P value of 0.05 or less was considered significant. CONCLUSION: By our placebo controlled clinical trial it has been proved that the incidence of PONV is nearly 60% in caesarean deliveries performed under DOI: 10.18410/jebmh/2015/736 ORIGINAL ARTICLE J of Evidence Based Med & Hlthcare, pISSN- 2349-2562, eISSN- 2349-2570/ Vol. 2/Issue 34/Aug. 24, 2015 Page 5294 spinal anaesthesia. On the basis of the present study it can be concluded that injection Granisetron in a dose of 1 mg. I.V. is much more effective in minimizing severe nausea and vomiting than ondansetron in a dose of 4 mg. I.V. and is free from the side effect headache which is a drawback of ondansetron. The use of granisetron as prophylactic antiemetic for high risk group may be recommended. Granisetron seems to be useful alternative and relatively safe drug for effective anti-emetic prophylaxis
