European Journal of Biomedical and Pharmaceutical Sciences

COMPARISON OF ANTIEMETIC EFFECT OF GRANISETRON AND PALONOSETRON IN PATIENTS UNDERGOING THYROIDECTOMY: A PROSPECTIVE, RANDOMIZED, DOUBLE-BLIND STUDY.

Dr. Yasir Nisar, *Dr. Aabid Hussain Mir, Dr Anisur Rehman, Dr Wasim Mohammad Bhat,
Dr Khalid Parvez, Dr. Showkat Hussain Nengroo and Dr Abida Yousuf

ABSTRACT

Background: Postoperative nausea and vomiting (PONV) is the second most frequent postoperative complaint after pain. The 5-hydroxytryptamine type-3 antagonists have proven a particularly valuable addition to the armamentarium against PONV. Granisetron has been very popular drug in this class for its efficacy and patient tolerability. Palonosetron is a second-generation 5-HT3 antagonist that has recently been approved for prophylaxis against PONV. It has unique structural, pharmacological and clinical properties that distinguish it from other agents in its class. This study compared the effects of intravenous granisetron and palonosetron administered five minutes before induction of anaesthesia in preventing postoperative nausea and vomiting (PONV) in patients undergoing thyroidectomy. Methods: 120 female patients of physical status ASA-I & ASA-II, 25-50 years of age, posted for elective thyroidectomy were enrolled in the study and randomly divided into two groups (group-G and group-P). Patients in group-G received 2.5 mg of granisetron and group-P received 0.075 mg of palonosetron intravenously five minutes before induction of anesthesia according to group assignment by an anesthesiologist not involved in the study. Incidence of nausea and vomiting, severity of nausea and vomiting, need for rescue anti emetics and side effects if any were evaluated at 0-2 hours, 2-24 hours and 24-48 hours after surgery. Results: The incidence of PONV during 24-48 hours postoperative period was lower in palonosetron group than in granisetron group (8.33% vs 31.66%, p-value=0.001) and was statistically significant however no differences were observed between the two groups at 0-2 hours and 2-24 hours. The severity of nausea and vomiting was significantly lower in the palonosetron group as compared to granisetron group at all study intervals. The number of patients requiring anti-emetics was statistically insignificant between the two groups at 0-2 hours and 2-24 hours postoperatively. However, the difference was statistically significant (p-value=0.025) at 24-48 hours postoperatively with 11 patients (18.33%) requiring rescue anti-emetics in group-G (Granisetron) and 2 patients (3.33%) in group-P (Palonosetron). Total number of rescue anti-emetics used in both the groups during 0-48 hours was 28, out of which 22(78.57%) were used in group-G (Granisetron) and 6 (21.43%) used in group-P (Palonosetron). Conclusions: From our study, we concluded that palonosetron is more effective than granisetron for antiemetic prophylaxis in patients undergoing thyroidectomy under general anesthesia.

Keywords: anti-emetics, granisetron; anti-emetics, palonosetron; postoperative nausea and vomiting; thyroidectomy.