A Comparative Study of Suppression of Post Operative nausea and vomiting in Elective Cesarean section under Spinal Anaesthesia using Granisetron, Granisetron+Dexamethasone and Granisetron + Dexamethasone+ Glycopyrrolate

This Study was done to compare efficacy and safety after antiemetic prophylaxis with Granisetron alone (Group I), Granisetron + Dexamethasone (Group II) and Granisetron+ Dexamethasone + Glycopyrrolate (Group III) in suppressing PONV in elective caesarian sections under spinal anaesthesia. The aim was to search for a better drug or combination of drugs for suppression of post operative nausea and vomiting (PONV), to compare haemodynamic changes, to observe side effects if any. Patients were allocated randomly into three different groups. Patients belonging to group I received- Inj.Granisetron 3mgIV, Group II received-Inj.Granisetron3mg+Dexamethasone4mgandgroup III received- Inj.Granisetron 3mg+Dexamethasone 4mg +Glycopyrrolate 0.2mg IV. Blood pressure, PR, SPO2 measurements were recorded upto 24 hours. Intra operative and postoperative nausea, retching and emetic episodes were recorded. Addition of Dexamethasone (4 mg) to Granisetron 3mg has shown better response in reducing nausea and vomiting. In Granisetron group significant fall in blood pressure was observed. Fluctuations in pulse rate were persistent for one hour in Granisetron + Dexamethasone + Glycopyrrolate group. Hence, it may be safer to use Granisetron + Dexamethasone combination perioperatively in view of its efficacy, safety, no haemodynamic alterations and no effect on fetal Apgar scores