A comparative study between ramosetron and granisetron for the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy

Abstract

Background: The reported incidence of postoperative nausea and vomiting (PONV) following laparoscopic cholecystectomy (LC) is very high. Various treatment modalities have been tried by several workers with varying results. This study was undertaken to compare the efficacy of ramosetron and granisetron with the intention to prevent postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy in this part of the country. Materials and Methods: In a randomized, double-blind study in our tertiary care hospital, 80 inpatients of ASA I and II were enrolled and received either 3 mg granisetron or 0.3 mg ramosetron i.v. (n = 40 each) ten minutes before induction of anesthesia. Standardized anesthetic technique was used, and data was collected for early (0-2 hr) PONV in the post-anesthetic care unit (PACU) and late (2-24 hr) PONV in the ward. Results: The incidence of early PONV (0-2 hr) was 22.5% for granisetron and 15% for ramosetron (P > 0.05; 95% Confidence interval (CI) = 0.20 to 1.97; OR = 0.63), late PONV (2-24 hr) was 25% and 15%, respectively (P > 0.05; CI = 0.18 to 1.68; OR = 0.56). The most common side-effects observed in the two groups were headache and drowsiness, and these were mild and self-limiting. There was no significant difference in the side-effects of drugs between the two groups. Conclusion: PONV is a distressing symptom in laparoscopic cholecystectomy cases, and ramosetron is as effective as granisetron in preventing early (0-2 hr) and late (2-24 hr) PONV.