We studied 45 ASA I/II children aged between 2 and 13 years scheduled for elective strabismus surgery, randomly allocated to receive either a peribulbar block or topical lidocaine 2% combined with general anaesthesia, or general anaesthesia alone. The incidence and severity of the occulocardiac reflex, the requirement for atropine, the occurrence of arrhythmias and incidence of postoperative nausea and vomiting following surgery at 1, 2 and 4 h were studied. We found the incidence and severity of occulocardiac reflex intra-operatively was significantly reduced in children who received a peribulbar block. The incidence of postoperative nausea and vomiting was significantly reduced in patients receiving either peribulbar block or topical local anaesthesia combined with general anaesthesia, compared to general anaesthesia alone (p = 0.008).
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CONTEXTA major factor behind this Day-Care surgery has been substantial savings in medical costs apart from increasing the convenience to the patient. From an anaesthetic viewpoint, one of the primary goals with respect to outpatient anaesthesia is prompt recovery with minimal side effects and quick discharge. AIMSTo compare the efficacy and side effects of ondansetron and granisetron in the prevention of Postoperative Nausea and Vomiting (PONV) in female patients of reproductive age group undergoing Day-Care surgery. SETTINGS AND DESIGNRandomised double blind. METHODS AND MATERIAL150 female patients, ASA I and II, between the age of 18-45 yrs. undergoing Day-Care surgery. The patients were randomly allocated to one of the three groups (50 in each group). Group C (n=50): Control group. Received normal saline 2 mL intravenously. Group G (n=50): Granisetron group received Inj. Granisetron 1 mg IV made to 2 mL with normal saline. Group O (n=50): Ondansetron group. Received Inj. Ondansetron 4 mg IV in 2 mL. Incidence of PONV was studied during two periods after surgery in the PACU (0-2 hrs.) and in the ward (2-6 hrs.). Patients were asked to rate nausea on a four-point scale as 0 -none, 1 -mild, 2 -moderate or 3 -severe. A telephonic interview was held with the patient 24 hours after surgery. This assessed the incidence of retching/vomiting, the incidence and severity of nausea and pain during the 24 hours after discharge. STATISTICAL ANALYSISANOVA, Chi-square, Fisher's Exact test was done. RESULTS9 patients (18%) in the placebo group suffered from vomiting, whereas only 6 (12%) in the ondansetron group and 3 (6%) in the granisetron group were affected. The incidence of PONV without prophylaxis was 20% with Group G (Inj. granisetron) was 10% and Group O (Inj. ondansetron) was 16%. This difference was not statistically significant in the 2-6 hours' period, Group G (Inj. granisetron) was found to be more effective than Group C (placebo) (p <0.05) in preventing vomiting. In the post discharge period (6-24 hrs.), Group G (Inj. granisetron) was more effective than Group C (placebo) (p <0.005) and Group O (Inj. ondansetron) (p <0.05) in the prevention of PONV. CONCLUSIONWe conclude either granisetron and ondansetron is equally effective for the control of PONV in the first 6 hours after Day-Care surgery, granisetron is more effective than ondansetron in the post-discharge period. KEYWORDS5-HT3 Antagonists, Granisetron, Ondansetron, Day-Care Surgery, Post-Operative Nausea and Vomiting. HOW TO CITE THIS ARTICLE:Kumar VS, Remadevi R, Pratheeba N. A comparative study of ondansetron and granisetron in the prevention of post-operative nausea and vomiting (PONV) in day-care surgery.
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