Comparison of ondansetron and granisetron for antiemetic prophylaxis in maxillofacial surgery patients receiving general anesthesia: a prospective, randomised, and double blind study
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Objectives: To compare the efficacy of intravenous ondansetron (4 mg, 2 mL) and granisetron (2 mg, 2 mL) for preventing postoperative nausea and vomiting (PONV) in patients during oral and maxillofacial surgical procedures under general anesthesia.Materials and Methods: A prospective, randomized, and double blind clinical study was carried out with 60 patients undergoing oral and maxil-lofacial surgical procedures under general anesthesia. Patients were divided into two groups of 30 individuals each. Approximately two minutes before induction of general anesthesia, each patient received either 4 mg (2 mL) ondansetron or 2 mg (2 mL) granisetron intravenously in a double blind man-ner. Balanced anesthetic technique was used for all patients. Patients were assessed for episodes of nausea, retching, vomiting, and the need for rescue antiemetic at intervals of 0-2, 3, 6, 12, and 24 hours after surgery. Incidence of complete response and adverse effects were assessed at 24 hours postop-eratively. Data was tabulated and subjected to statistical analysis using the chi-square test, unpaired t-test, or the Mann-Whitney U-test as appropriate. A P-value less than 0.05 was considered statistically significant. Results: There was no statistically significant difference between the two groups for incidence of PONV or the need for rescue antiemetic. Both study drugs were well tolerated with minimum adverse effects; the most common adverse effect was headache. The overall incidence of complete response in the granisetron group (86.7%) was significantly higher than the ondansetron group (60.0%). Conclusion: Granisetron at an intravenous dose of 2 mg was found to be safe, well tolerated, and more effective by increasing the incidence of com-plete response compared to 4 mg intravenous ondansetron when used for antiemetic prophylaxis in maxillofacial surgery patients receiving general anesthesia. Benefits of granisetron include high receptor specificity and high potency, which make it a valuable alternative to ondansetron.
Abstract
Objectives: To compare the efficacy of intravenous ondansetron (4 mg, 2 mL) and granisetron (2 mg, 2 mL) for preventing postoperative nausea and vomiting (PONV) in patients during oral and maxillofacial surgical procedures under general anesthesia.Materials and Methods: A prospective, randomized, and double blind clinical study was carried out with 60 patients undergoing oral and maxil-lofacial surgical procedures under general anesthesia. Patients were divided into two groups of 30 individuals each. Approximately two minutes before induction of general anesthesia, each patient received either 4 mg (2 mL) ondansetron or 2 mg (2 mL) granisetron intravenously in a double blind man-ner. Balanced anesthetic technique was used for all patients. Patients were assessed for episodes of nausea, retching, vomiting, and the need for rescue antiemetic at intervals of 0-2, 3, 6, 12, and 24 hours after surgery. Incidence of complete response and adverse effects were assessed at 24 hours postop-eratively. Data was tabulated and subjected to statistical analysis using the chi-square test, unpaired t-test, or the Mann-Whitney U-test as appropriate. A P-value less than 0.05 was considered statistically significant. Results: There was no statistically significant difference between the two groups for incidence of PONV or the need for rescue antiemetic. Both study drugs were well tolerated with minimum adverse effects; the most common adverse effect was headache. The overall incidence of complete response in the granisetron group (86.7%) was significantly higher than the ondansetron group (60.0%). Conclusion: Granisetron at an intravenous dose of 2 mg was found to be safe, well tolerated, and more effective by increasing the incidence of com-plete response compared to 4 mg intravenous ondansetron when used for antiemetic prophylaxis in maxillofacial surgery patients receiving general anesthesia. Benefits of granisetron include high receptor specificity and high potency, which make it a valuable alternative to ondansetron.
참고문헌 (23)
- Talesh KT, "Comparison of ondansetron and metoclopramide antiemetic prophylaxis in maxillofacial surgery patients", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 111, pp.275~277 (2011)
- Bhattacharya D, "Comparison of ondansetron and granisetron for prevention of nausea and vomiting following day care gynaecological laparoscopy", Indian J Anaesth, 47, pp.279~282 (2003)
- Leeser J, "Prevention of postoperative nausea and vomiting using ondansetron, a new, selective, 5-HT3 receptor antagonist", Anesth Analg, 72, pp.751~755 (1991)
- McKenzie R, "Comparison of ondansetron versus placebo to prevent postoperative nausea and vomiting in women undergoing ambulatory gynecologic surgery", Anesthesiology, 78, pp.21~28 (1993)
- Honkavaara P, "Effect of ondansetron on nausea and vomiting after middle ear surgery during general anaesthesia", Br J Anaesth, 76, pp.316~318 (1996)
- Dershwitz M, "A randomized, double-blind, dose-response study of ondansetron in the prevention of postoperative nausea and vomiting", J Clin Anesth, 10, pp.314~320 (1998)
- Liberman MA, "Ondansetron versus placebo for prophylaxis of nausea and vomiting in patients undergoing ambulatory laparoscopic cholecystectomy", Am J Surg, 179, pp.60~62 (2000)
- Rodrigo C, "The effect of a 4-mg preoperative intravenous dose of ondansetron in preventing nausea and vomiting after maxillofacial surgery", J Oral Maxillofac Surg, 54, pp.1171~1175 (1996)
- Wagley C, "The effect of preoperative ondansetron on the incidence of postoperative nausea and vomiting in patients undergoing outpatient dentoalveolar surgery and general anesthesia", J Oral Maxillofac Surg, 57, pp.1195~1200 (1999)
- Kovac AL, "The prophylactic treatment of postoperative nausea and vomiting in oral and maxillofacial surgery", J Oral Maxillofac Surg, 63, pp.1531~1535 (2005)
- Kovac AL, "Efficacy of repeat intravenous dosing of ondansetron in controlling postoperative nausea and vomiting: a randomized, double-blind, placebo-controlled multicenter trial", J Clin Anesth, 11, pp.453~459 (1999)
- Smith HS, "5-HT3 receptor antagonists for the treatment of nausea", vomiting, 2012, pp.1, 115~120
- Pasricha PJ, "Goodman and Gilman's the pharmacological basis of therapeutics", pp.1021~1036 (2001), McGraw-Hill
- Facts and Comparisons (Firm), "Drug facts and comparisons 2003" (2003), Facts and Comparisons
- Aapro M, "Granisetron: an update on its clinical use in the management of nausea and vomiting", Oncologist, 9, pp.673~686 (2004)
- Fujii Y, "Comparison of ramosetron and granisetron for preventing postoperative nausea and vomiting after gynecologic surgery", Anesth Analg, 89, pp.476~479 (1999)
- Kovac AL, "S3A-379 Study Group. Ondansetron prevents postoperative emesis in male outpatients", J Clin Anesth, 8, pp.644~651 (1996)
- Fujii Y, "Optimal anti-emetic dose of granisetron for preventing postoperative nausea and vomiting", Can J Anaesth, 41, pp.794~797 (1994)
- Mikawa K, "The antiemetic efficacy of prophylactic granisetron in gynecologic surgery", Anesth Analg, 80, pp.970~974 (1995)
- Fujii Y, "Granisetron reduces the incidence of nausea and vomiting after middle ear surgery", Br J Anaesth, 79, pp.539~540 (1997)
- Figueredo ED, "Ondansetron in the prophylaxis of postoperative vomiting: a meta-analysis", J Clin Anesth, 10, pp.211~221 (1998)
- Bestas A, "Effects of ondansetron and granisetron on postoperative nausea and vomiting in adult patients undergoing laparoscopic cholecystectomy: a randomized, double-blind, placebo-controlled clinical trial", Curr Ther Res Clin Exp, 68, pp.303~312 (2007)
- Naguib M, "Prophylactic antiemetic therapy with ondansetron, tropisetron, granisetron and metoclopramide in patients undergoing laparoscopic cholecystectomy: a randomized, doubleblind comparison with placebo", Can J Anaesth, 43, pp.226~231 (1996)