Prophylactic Antiemetic Therapy With Ondansetron, Granisetron And Metoclopramide In Patients Undergoing Laparoscopic Cholecystectomy Under General Anaesthesia

Nausea and vomiting is a common and distressing complication for patients with virtually all types of surgical procedures, its consequences being physical (like sweating, tachycardia, electrolyte imbalance) surgical (disruption of vascular anastamosis) and anaesthetic (aspiration pneumonitis). The aim of the present study was to compare the antiemetic effect of intravenous granisetron 3mg, ondansetron 4mg & metoclopramide 10mg in a randomized double blind study for prophylaxis of post operative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy under general anaesthesia. 60 patients (ASA I & II) undergoing laparoscopic cholecystectomy under general anaesthesia were randomly allocated into three equal groups. Group A (n=20) received 4mg ondansetron, Group B (n=20) 3mg granisetron and group C (n=20) metoclopramide 10mg. The drugs were diluted in 50ml normal saline and given intravenous slowly over 10mins before induction of anaesthesia. Anaesthesia procedure was common to all the patients. Emetic episodes in first 24 hours were recorded and compared in different study groups. Results were analyzed using chi square test. A value of p < 0.05 was considered to be significant. Emetic episodes were observed in 45% patients in group B, 70% patients in Group-A and 95% patients in group C. To conclude, minimal emetic episodes were observed in early post-operative period (1-12hrs) in patients who had received intravenous granisetron in comparison to ondansetron and metoclopramide. However, after 12 hours emesis free periods were statistically insignificant between group A and B while patients in group C had no antiemetic effect.