مرکز منطقه ای اطلاع رساني علوم و فناوري - The effect of granisetron dexamethasone combination on postoperative nausea and vomiting in gynecological operations

Abstract :

Objectives: Postoperative nausea and vomiting (PONV) is one of the most frequent adverse effects of anesthesia. PONV postpones hospital stays and also delays recover and getting better, of the patients. The objective of the current study is to compare efficacy of prophylactic granisetron (40 μ/kg) + dexamethasone (4 mg) combination against PONV in different anesthesia models.Materials and Methods: 72 patients with an age range of 18-72 years and ASA 1 or 2 were enrolled in the present study. The patients were assigned as group 1 propofol-remifentanil (P-R), group 2 propofol- nitrous oxide (P-N2O), group 3 sevoflurane- nitrous oxide (S-N2O) and group 4 sevoflurane-remifentanyl-air (S-R+H). Inductions of the patients in all groups were made with intravenous 2-3 mg/kg propofol, 1μ/kg remifentanil and 0.2 mg/kg cis-atracurium. 4 mg of dexamethasone by bolus and 40 μ/kg of granisetron by infusion were administered to the patients in all groups after induction. During the last 10 minutes of the operation, 1mg/kg tramadol was administered. Postoperative nausea and vomiting, VAS scores, and additional antiemetic needs were recorded during postoperative 48 hours.Results: Postoperative 48 hours follow up revealed that PONV was seen 27%, 16%, 38%, 48% frequencies in (P+R), (P+ N2O), (S+ N2O), (S+R+H) groups, respectively. While antiemetic requirement was not observed in (P+ N2O) and (S+ N2O) groups, the patients in (P+R) and (S+R+H) groups needed additional antiemetic drugs with a frequency of 5.5% and 11% respectively.Conclusion: Granisetron, dexamethasone combination in different anesthetic models did not reveal significant difference in terms of postoperative nausea, vomiting, and additional antiemetic usage.