A COMPARATIVE STUDY OF ONDANSETRON AND GRANISETRON IN THE PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING (PONV) IN DAY-CARE SURGERY

CONTEXT A 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. AIMS To 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 DESIGN Randomised double blind. METHODS AND MATERIAL 150 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 (02 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 ANALYSIS ANOVA, Chi-square, Fisher's Exact test was done. RESULTS 9 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. CONCLUSION We 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.