A Comparative Evaluation of Ondansteron and Granisteron with Dexamethasone Combination in Prevention of Nausea and Vomiting Following post Operative Laparoscopic Cholecystectomy

ABSTRACT

ackground Post operative nausea and vomiting (PONV) have been considered among most distressing symptoms after surgery under anaesthesia. Different combinations of anti-emetic drugs have been used but no drug has achieved 100% efficacy in reducing PONV after laparoscopic surgery. Therefore, the present study was designed to assess if there is any effect of granisetron and ondansetron with dexamethasone in prevention of PONV after general anaesthesia for laparoscopic cholecystectomy. Methods: The study population was divided into three groups according to introduced combination of drugs. Group I (n=50), group II (n=50) and group III (n=50) were introduced Ondansetron (4mg) & Dexamethasone 8mg, Granisetron (1mg) & Dexamethasone 8mg and Normal saline & Dexamethasone 8mg respectively. VAS scale from 0-10 was used to assess the intensity of pain after operation. PONV scoring system considering 0 as no nausea, 1 as nausea and 3 as vomiting was incorporated in this study. Results: The incidence of PONV (score-1,2,3) are tabulated at intervals of 6 hours and complete response was noted in all three groups. There was no statistical difference observed between group I and II in first 24 hours but significant difference was observed between group I, group II and control group III. Complete response score 96%, 98% and 56% respectively for group I, group II and group III correspondingly after at 6 to 12 hours. Conclusion: Findings of the present study suggest that PONV was significantly decreased in group I ondansetron & dexamethasone and group II of granisetron & dexamethasone. Therefore, we strongly suggest that combination of dexamethasone either with ondansetron or granisetron are equally effective in decreasing incidence of PONV in laparoscopic cholecystectomy patients as prophylaxis.