ABSTRACT
Laparoscopic bariatric surgeries are associated with an appreciably high rate of postoperative nausea and vomiting. This study was designed to compare the effectiveness of granisetron either alone or in combination with droperidol or dexamethasone, for the prevention of post operative nausea and vomiting [PONV] in patients undergoing laparoscopic bariatric surgeries. In a randomized, double-blind, placebo-controlled trial, 120 patients received either Granisetron 1 mg, Granisetron 1 mg plus Droperidol 1.25 mg, Granisetron 1 mg plus Dexamethasone 8 mg or Placebo [saline], intravenously immediately before induction of anesthesia. Perioperative anesthetic care was standardized in all patients. Patients were then observed for 24 hours after administration of the study drugs. The incidence of PONV was 30% with granisetron alone, 30% with granisetron plus droperidol, 20%, with granisetron plus dexamethanone, and 67% with placebo [P < 0.05; overall Fisher's exactprobability test]. The incidence of adverse events was not different among the 4 groups. Graniserton is effective and safe drug for reducing the incidence of PONV in patients undergoing bariatric surgeries, and becomes highly effective when combined with dexamethasone
Subject(s)
Humans , Male , Female , Laparoscopy/drug effects , Double-Blind Method , /adverse effects , Postoperative Complications/therapy , Postoperative Complications/drug therapy , Granisetron , Postoperative Nausea and Vomiting/drug therapy , Postoperative Nausea and Vomiting/etiology , Droperidol , Dexamethasone , Prospective StudiesABSTRACT
Laparoscopic surgery is commonly performed as a day case surgery procedure despite difficulties in providing adequate postoperative analgesia for all patients were examined. The analgesic utility of intramuscular piroxicam have been studied in this setting by comparing it with intramuscular pethidine, both given after induction of anesthesia in a randomized double blind study in 60 patients. Although, the analgesic effect of 2 drugs were comparable in the immediate postoperative period, piroxicam provided significantly better analgesia four hours after surgery. The recovery time taken to awake, to ambulate and for discharge were all significantly shorter after piroxicam and the unplanned admission rate also significantly less after piroxicam. Piroxicam appeared to be useful supplement for analgesia after laparoscopic surgery, providing improved analgesia as well as decreased recovery time and fewer unplanned admissions