Skip to main content
Log in

Randomized Double Blind Comparative Study Comparing Efficacy of Granisetron and Ondansetron for the Prophylactic Control of Postoperative Nausea and Vomiting in Patients Undergoing Middle Ear Surgery

  • Original Article
  • Published:
Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

The objective is to evaluate the prophylactic profile, efficacy of granisetron and ondansetron to prevent postoperative nausea and vomiting (PONV) after middle ear surgery. In a randomized, double blind trial, one hundred patients undergoing middle ear surgery received either granisetron 1 mg or ondansetron 8 mg in equal volume (n = 50 for each) intravenously towards the end of surgery and before reversal of anaesthesia. A standard general anaesthetic technique was employed. Postoperatively, during the first 24 h after anaesthesia, the incidence of PONV, recovery score, time to first feeding, willingness to have the same prophylactic antiemetic drug in future and adverse events were recorded. The incidence of vomiting once (PONV score 2) was significantly less, 4% with granisetron and 22% with ondansetron (P = 0.002) respectively and the incidence of vomiting twice or more times in 30 min interval (PONV score 3) was significantly less, 8% with granisetron as compared to 34% with ondansetron (P = 0.001). The requirement of rescue antiemetic drug was significantly higher in ondansetron group, i.e. 34 vs. 8% in granisetron group (P = 0.001). The incidence of adverse events, recovery score and time to first feeding were comparable among the groups. Willingness to have the same prophylactic antiemetic drug in future was significantly high in patients receiving granisetron. Granisetron is more efficacious and desirable drug than ondansetron for reducing the incidence of PONV in patients undergoing middle ear surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Honkavaara P, Saarinvaara L, Klemola U-K (1994) Prevention of nausea and vomiting with transdermal hyoscine in adults after middle ear surgery during general anaesthesia. Br J Anaesth 73:763–766

    Article  CAS  PubMed  Google Scholar 

  2. Reinhart DJ, Klein KW, Schroff E (1994) Transdermal scopolamine for the reduction of postoperative nausea in outpatient ear surgery: a double blind, randomized study. Anesth Analg 79:281–284

    Article  CAS  PubMed  Google Scholar 

  3. Kovac AL (2006) Meta-analysis of the use of rescue antiemetics following PONV prophylactic failure with 5-HT3 antagonist/dexamethasone versus Single agent therapies. Ann Pharmacol 40:873–887

    Article  CAS  Google Scholar 

  4. Watcha MF, White PF (1992) Post operative nausea and vomiting, its etiology, treatment and prevention. Anaesthesiology 77:162–184

    Article  CAS  Google Scholar 

  5. Andrews PLR, Bhandari P, Davey PT, Bingham S, Marr HE, Blower PR (1992) Are all 5-HT3 receptor antagonists the same? Eur J Cancer 28:S2–S6

    Article  Google Scholar 

  6. Fujji Y, Toyooka H, Tanaka H (1997) Granisetron reduces the incidence of nausea and vomiting following middle ear surgery. Br J Anaesth 79:539–540

    Article  Google Scholar 

  7. Fujji Y, Toyooka H, Tanaka H (1998) Granisetron in the prevention of nausea and vomiting following middle ear surgery: a dose ranging study. Br J Anaesth 80:764–766

    Article  Google Scholar 

  8. Watcha MF, White PF (1992) Postoperative nausea and vomiting. Its etiology, treatment and prevention. Anesthesiology 77:162–184

    Article  CAS  PubMed  Google Scholar 

  9. Ishizaki H, Pyykkö I, Aalto H, Starck J (1991) Tullio phenomenon and postural stability: EXPERIMENTAL study in normal subjects and patients with vertigo. Ann Otol Rhinol Laryngol 100:976–983

    CAS  PubMed  Google Scholar 

  10. Fujji Y, Toyooka H, Kobayashi N (1999) Prevention of nausea and vomiting after middle ear surgery: granisetron versus ramosetron. Laryngoscope 109:1988–1990

    Article  Google Scholar 

  11. Fujji Y, Toyooka H, Kobayashi N (2001) Prevention of postoperative nausea and vomiting with antiemetics in patients undergoing middle ear surgery: comparison of a small dose of propofol with droperidol or metoclopramide. Arch Otolaryngol Head Neck Surg 127:25–28

    Article  Google Scholar 

  12. Fujji Y, Toyooka H, Tanaka H (1998) Prophylactic antiemetic therapy with granisetron, droperidol and metoclopramide in female patients undergoing middle ear surgery. Anaesthesia 53:1165–1168

    Article  Google Scholar 

  13. Gigillo CA, Soares H, Castro CP et al (2000) Granisetron is equivalent to ondansetron for prophylaxis of chemotherapy-induced nausea and vomiting. Results of a meta analysis of randomized controlled trials. Cancer 89:2301–2308

    Article  Google Scholar 

  14. Fujii Y, Tanaka H, Toyooka H (1997) Granisetron reduces incidence of nausea and vomiting after breast surgery. Acta Anaesthesiol 41:746–749

    Article  CAS  Google Scholar 

  15. Wilson AJ, Diemunsch P, Lindeque BG, Scheinin H, Helbo-Henson HS, Kroeks MVAM, Kong KL (1996) Single dose i.v. granisetron in the prevention of postoperative nausea and vomiting. Br J Anaesth 76:515–518

    Article  CAS  PubMed  Google Scholar 

  16. Dua N, Bhatnagar S, Mishra S, Singhal AK (2004) Granisetron and ondansetron for prevention of nausea and vomiting in patients undergoing modified radical mastectomy. Anaesth Intensive Care 32:761–764

    CAS  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Naresh Dua.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dua, N., Sethi, N., Sood, J. et al. Randomized Double Blind Comparative Study Comparing Efficacy of Granisetron and Ondansetron for the Prophylactic Control of Postoperative Nausea and Vomiting in Patients Undergoing Middle Ear Surgery. Indian J Otolaryngol Head Neck Surg 66 (Suppl 1), 252–256 (2014). https://doi.org/10.1007/s12070-011-0464-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12070-011-0464-7

Keywords

Navigation