To Compare The Efficacy Of Ramosetron And Granisetron In Prevention Of Post Operative Nausea And Vomiting In Patients Undergoing Laparoscopic Appendicectomy Under General Anaesthesia – A One Year Randomized Controlled Trial

Abstract

Background and objectives Postoperative nausea and vomiting (PONV) is one of the common side effects faced by anaesthesiologists in day to day practice. It is physiologically and emotionally an unpleasant experience for the patient in the early postoperative period. The incidence of PONV is between 20 to 30% in patients recovering from anaesthesia. The main objective of this study was to compare the efficacy of ramosetron and granisetron in preventing PONV in patients undergoing laparoscopic appendicectomy under general anaesthesia. Methodology: The study was conducted in the Department of Anaesthesiology, KLE’S Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi in patients undergoing laparoscopic appendicectomy between January 2014 to December 2014. Approval from the ethical committee was obtained. Written informed consent was taken from the patients who were to be included in this study. ASA I and II patients in the age group of 18 to 60 years who underwent laparoscopic appendicectomy were included in the study. They were then randomly divided into two groups: Group R (Ramosetron) and Group G (Granisetron) using a computer generated table. After extubation the incidence of PONV was recorded every six hours using the PONV scoring system. 0 – No nausea 1 – Nausea 2 – Retching 3 – Vomiting Patients with PONV score ≥2 received injection dexamethasone 0.1mg/kg IV as rescue anti-emetic. Results PONV scores were lower in the ramosetron group and the difference was significant in the first 18 hours. PONV incidence (PONV score≥1) was 1.5%, 3.6% and 9.1% in Group R compared to 61.9%, 61.9%and 34.5% in Group G during the first, second and third six hours post-operatively (p-value<0.001). Incidence of emetic episodes (PONV score≥2) was similar in both the groups (p-value>0.05). Conclusions From our study we conclude that ramosetron is better than granisetron at preventing PONV after laparoscopic appendicectomy under general anaesthesia. We also found that both are equally effective at preventing emetic episodes.