Granisetron vs. Granisetron and Dexamethasone on The Reduction of Postoperative Nausea and Vomiting (PONV) After Caesarean Section With Intrathecal Morphine: A Randomised Controlled Trial

Abstract

ABSTRACT Background Intrathecal morphine (ITM) has proven to be excellent in reducing postoperative pain. However, its use is associated with the occurrence of postoperative nausea and vomiting (PONV). In this study, we wish to compare the efficacy between the combination therapy of granisetron and dexamethasone versus granisetron alone on the occurrence of postoperative nausea and vomiting (PONV) in parturients undergoing elective Caesarean delivery. Method This is a prospective double-blinded, randomised controlled trial (RCT) involving 126 parturients of American Society of Anesthesiologist (ASA) physical status I and II undergoing elective Caesarean deliveries. Subjects were randomly allocated into 2 groups (n = 63), to either receive a combination of 1 mg intravenous (IV) granisetron plus 4 mg IV dexamethasone (Group A) or to receive 1 mg IV granisetron (Group B). They were assessed at 1, 4, 8, 12 and 24-hour postoperatively. Episodes of nausea, retching, vomiting and the requirement of rescue antiemetics at these time intervals were recorded. Results There are no statistically significant differences in the occurrence of nausea, retching and vomiting between both groups at 1, 4, 8, 12 and 24 h postoperatively. The usage of rescue antiemetics were similar in both groups of subjects. Conclusion The use of granisetron is comparable with the use of granisetron and dexamethasone in the prevention of PONV in parturients receiving intrathecal morphine for elective Caesarean section.