A Comparative Study between Palonosetron and Granisetron to Prevent Postoperative Nausea and Vomiting after Laparoscopic Cholecystectomy

Abstract

Aim: This study aims to Compare Granisetron and Palonosetron for prevention of postoperative nausea and vomiting following laparoscopic surgery.

Materials and Methods: This study was conducted on 80 patients in the Department of Anesthesiology, Critical Care, and Pain Management. The inclusion criteria were patients with ASA physical class 1 and 2, patients in the Age between 20 to 70 yrs, patients who undergone Elective laparoscopic Cholecystectomy. Exclusion criteria included patients with ASA physical class 3 and above, patients with Inability to understand or co-operate with the study, The study design was prospective randomized, single blind comparative study. Group A: Received 40 mcg/kg Granisetron IV. Group B: Received 0.075 mg Palonosetron IV. At the completion of surgery patients received Neostigmine 0.05mg/kg and Glycopyrrolate 0.01mg/kg for several of Neuro muscular blockage. Nausea according to verbal descriptive scale (VDS) (0=no nausea, 1= mild nausea, 2=moderate nausea, 3= severe nausea) use of rescue antiemetic drug and adverse effect was monitored at 0- 2hrs, 2-6hrs and 6-24hrs.

Statistical Analysis and Results: SPSS software version 23.0 was used for our statistical analysis, Mean age in Granisetron group was 47±15 and in Palonosetron group was 45±14. The p-value is 0.667607. There was no significant difference in the mean age between the groups. Mean baseline SBP in Granisetron group was 123.4±13.5775 mmHg and in Palonosetron group was 128.425±13.013 mmHg. There was no significant difference in the SBP between two groups. In the study mean duration of surgery in Granisetron group was 1.22±13 hrs and in Palonosetron group was 1.2±22 hrs. There was no significant in episodes of vomiting between the two groups at 0 to 2 hrs, 2 to 6 hrs and 6 to 24 hrs. There was no significant difference in the use of rescue anti emetic drugs at 0 to 2 hrs, 2 to 6 hrs and 6 to 24 hrs between the both groups. The numbers of patients free of nausea at 24 hrs were more in Granisetron group as compared to Palonosetron.

Conclusion: Authors concluded that patients receiving Palonosetron had less incidence of vomiting than Granisetron group but the difference was not statistically significant during 0-2, 2-6 and 6-24 hours. The number of patients free of nausea vomiting was significantly lower in Palonosetron group than Granisetron at the end of 24 hrs. Therefore, both Granisetron and Palonosetron are equally effective in the immediate post operative period but palonosetron is more effective over 24 hour’s period.