Randomized Double Blind Comparative Study Comparing Efficacy of Granisetron and Ondansetron for the Prophylactic Control of Postoperative Nausea and Vomiting in Patients Undergoing Middle Ear Surgery

Abstract

The objective is to evaluate the prophylactic profile, efficacy of granisetron and ondansetron to prevent postoperative nausea and vomiting (PONV) after middle ear surgery. In a randomized, double blind trial, one hundred patients undergoing middle ear surgery received either granisetron 1 mg or ondansetron 8 mg in equal volume (n = 50 for each) intravenously towards the end of surgery and before reversal of anaesthesia. A standard general anaesthetic technique was employed. Postoperatively, during the first 24 h after anaesthesia, the incidence of PONV, recovery score, time to first feeding, willingness to have the same prophylactic antiemetic drug in future and adverse events were recorded. The incidence of vomiting once (PONV score 2) was significantly less, 4% with granisetron and 22% with ondansetron (P = 0.002) respectively and the incidence of vomiting twice or more times in 30 min interval (PONV score 3) was significantly less, 8% with granisetron as compared to 34% with ondansetron (P = 0.001). The requirement of rescue antiemetic drug was significantly higher in ondansetron group, i.e. 34 vs. 8% in granisetron group (P = 0.001). The incidence of adverse events, recovery score and time to first feeding were comparable among the groups. Willingness to have the same prophylactic antiemetic drug in future was significantly high in patients receiving granisetron. Granisetron is more efficacious and desirable drug than ondansetron for reducing the incidence of PONV in patients undergoing middle ear surgery.

Granisetron versus Granisetron-Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Pediatric Strabismus Surgery: A Randomized Double-Blind Trial

“…In a meta-analysis by Shen et al dexamethasone and ondansetron have been found to be more effective at reduction of PONV in comparison to ondansetron after strabismus surgery [ 23 ]. As granisetron is more efficacious than ondansetron in prevention of PONV [ 24 , 25 ], it is possible that dexamethasone cannot further enhance the efficacy of granisetron in strabismus surgery as seen in our study. Again, efficacy of any drug in preventing an undesirable response also depends upon the baseline risks of the patients.…”

Comparative Evaluation of Single Dose Palonosetron and Granisetron in Middle Ear Surgeries for Prevention of Postoperative Nausea and Vomiting.

“…This given property can be utilized for prevention of PONV where longer duration prophylaxis is required as in cases of middle ear surgeries. Granisetron with half life of eight to nine hours is also effective in preventing PONV by causing irreversible blockade of 5HT3 receptor on vagal 11,12 afferents from gut .…”