A COMPARATIVE STUDY OF GRANISETRON, RAMOSETRON AND PALONOSETRON AS ANTIEMETICS IN PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING IN PATIENTS UNDERGOING LAPAROSCOPIC SURGERIES

BACKGROUND Postoperative Nausea and Vomiting (PONV) are the most unpleasant side effects after surgery. The incidence of PONV after laparoscopic surgery is high (40-75%). The purpose of this study was to prospectively evaluate the efficacy of granisetron, ramosetron and palonosetron for the prevention of PONV in patients undergoing laparoscopic surgery. METHODS In this prospective, randomized observational study, 90 healthy patients who were undergoing abdominal laparoscopic surgery under general anaesthesia were enrolled. Patients were divided into three groups. Group A received Inj. granisetron (1 mg), group B received Inj. ramosetron (0.3 mg), and Group C received Inj. palonosetron (0.075 mg) intravenously five minutes before induction of anaesthesia. The incidence of nausea, vomiting, retching, rescue antiemetic requirements and complete response during the first 24 h after surgery were evaluated. RESULTS The number of complete responders during 0-4 h were 24 (80.00%) for Palonosetron, 23 (76.67%) for Ramosetron and 21 (70.00%) for Granisetron, which was statistically nonsignificant. During 4-12 h number of complete responders were 26 (86.67%) for Palonosetron, 25 (83.33%) for Ramosetron and 22 (73.33%) for Granisetron representing a significant difference (p=0.021) between Granisetron and Palonosetron, while Granisetron vs Ramosetron (p=0.092) and Ramosetron vs Palonosetron (p=0.513) showed non-significant differences. Similarly, during 12-24 h number of complete responders were 28 (93.00%) for Palonosetron, 26 (86.67%) for Ramosetron and 24 (80.00%) for Granisetron representing a significant difference (p=0.011) between Granisetron and Palonosetron. The incidence of PONV during 4-12 h and 12-24 h also showed a significant difference between Granisetron and Palonosetron. CONCLUSIONS The antiemetic effect of Palonosetron is better than Granisetron, whereas there was no significant difference in the antiemetic efficacy of Granisetron and Ramosetron as well as between Ramosetron and Palonosetron in patients undergoing laparoscopic surgery.