Rakesh Kumar Singh1, Sipra Singh2
BACKGROUND
Postoperative nausea and vomiting is (PONV) a very distressing complication and preventive measures are justified when the risk of PONV is very high. Ondansetron is the first 5-HT3 antagonist used alone or in combination for prophylaxis of PONV due to its lower cost. Granisetron and palonosetron are recently introduced 5-HT3 antagonists with greater affinity for 5-HT3 receptor and having longer half-life. Aim of the present study is to compare the antiemetic efficacy of ondansetron, granisetron and palonosetron in high-risk patients undergoing abdominal hysterectomy under general anaesthesia.
METHODS
After obtaining Institutional Ethical Committee approval and written informed consent from all the participants, 150 patients of ASA grade I & II, aged between 20-50 years and weight between 30-60 kg undergoing abdominal hysterectomy under general anaesthesia were assigned randomly in to three groups of 50 patients each using random number table receiving either ondansetron 4 mg (Group O) or granisetron 2 mg (Group G) or palonosetron 0.75 mg (Group P) intravenously just before the induction of anaesthesia. Incidence and severity of nausea and frequency of retching and vomiting were recorded in each group at the end of 2-hour and then at 24-hour and 48-hour intervals.
RESULTS
The incidence of nausea during first two hours postoperatively was found to be 14(28%) in Group O, which was found to be significantly higher than 6(12%) in group G and 4(8%) in group P (p value = 0.016). The incidence of vomiting was found to be 6(12%) in group O, which was found to be significantly higher than 2(4%) in both group G and group P (p value = 0.018). Number of complete responders was significantly higher in Group P and group G as compared to group O. Number of patients requiring rescue antiemetic treatment was significantly high in group O{10(20%)} as compared to 3(6%) in both the group G and group P.
CONCLUSIONS
Newly introduced 5-HT3 antagonists, granisetron and palonosetron are better in efficacy in the prophylaxis of nausea and vomiting. Both granisetron and palonosetron are comparable in efficacy to control postoperative nausea and vomiting.
