| Estudio prospectivo, randomizado, doble ciego y controlado con placebo comparando el efecto aditivo de midazolam y clonidina orales en la profilaxis de nausea y vomito en pacientes premedicados con ganisetron operados de colecistectomía laparoscópica. |
A prospective, randomized, double blind and placebo-control study comparing the additive effect of oral midazolam and clonidine for postoperative nausea and vomiting prophylaxis in granisetron premedicated patients undergoing laparoscopic cholecystecomy.
Yadav G, Pratihary BN, Jain G, Paswan AK, Mishra LD.
Department of Anesthesiology, Sir Sunder Lal Hospital, Institute of Medical Sciences, BHU, Varanasi, Uttar Pradesh, India.
J Anaesthesiol Clin Pharmacol. 2013 Jan;29(1):61-5. doi: 10.4103/0970-9185.105800.
Abstract
BACKGROUND: Reduction of postoperative nausea and vomiting (PONV) continues to be a major challenge in perioperative care in spite of introduction of newer antiemetics with better efficacy and safety profiles. Therefore, we evaluated the additive effect of oral midazolam and clonidine for PONV prophylaxis in granisetron premedicated patients undergoing laparoscopic cholecystectomy. MATERIALS AND METHODS: In a prospective, randomized fashion, 120 selected cases were randomized into three groups: I, II or III to receive a tablet of midazolam (15 mg, n = 36), clonidine (150 mcg, n = 40), or glucose as placebo (5 g, n = 44) orally, 1 h before anesthesia. Occurrence of PONV along with need for rescue antiemetic during the first postoperative day was compared between groups as a primary outcome. RESULTS: Episodes of PONV reduced significantly in Group II (15%) as compared to group I and III (22.2%, 59%) at various time points during the period of observation (P = 0.002). Need for rescue antiemetic was significantly lower in group I (13.88%) and II (5%) as compared to group III (52.27%, P < 0.001). CONCLUSION: Oral clonidine is better adjuvant for PONV prophylaxis, as compared to midazolam, in granisetron premedicated patients undergoing laparoscopic cholecystectomy.
KEYWORDS: Clonidine, PONV prophylaxis, granisetron premedicated, midazolam
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3590545/
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| Granisetron versus tropisetron en la prevención de nausea y vomito después de tiroidectomía total |
Granisetron versus tropisetron in the prevention of postoperative nausea and vomiting after total thyroidectomy.
Papadima A, Gourgiotis S, Lagoudianakis E, Pappas A, Seretis C, Antonakis PT, Markogiannakis H, Makri I, Manouras A.
Saudi J Anaesth [serial online] 2013 [cited 2013 Mar 30];7:68-74
Abstract
Background: Postoperative nausea and vomiting (PONV) are frequently encountered after thyroidectomy. For PONV prevention, selective serotonin 5-hydroxytryptamine type 3 (5-HT 3 ) receptor antagonists are considered one of the first-line therapy. We report on the efficiency of granisetron and tropisetron, with that of placebo on the prevention of PONV in patients undergoing total thyroidectomy. Methods: One hundred twenty-seven patients were divided into three groups and randomized to receive intravenously, prior to induction of anesthesia, tropisetron 5 mg, or granisetron 3 mg, or normal saline. All patients received additionally 0.625 mg droperidol. All episodes of postoperative PONV during the first 24 h after surgery were evaluated. Results: Nausea visual analogue scale (VAS) score was lower in tropisetron and granisetron groups than the control group at all measurements ( P<0.01) except for the 8-h measurement for tropisetron ( P=0.075). Moreover, granisetron performed better than tropisetron ( P<0.011 at 4 h and P<0.01 at all other points of time) apart from the 2-h measurement. Vomiting occurred in 22.2%, 27.5%, and 37.5% in granisetron, tropisetron, and control groups, respectively ( P=0.43). Conclusions: The combination of the 5-HT 3 antagonists with droperidol given before induction of anesthesia is well tolerated and superior to droperidol alone in preventing nausea but not vomiting after total thyroidectomy.
Keywords: Nausea, vomiting, thyroidectomy, granisetron, tropisetron
http://www.saudija.org/text.asp?2013/7/1/68/109817
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| ¿Puede el granisetron inyectado como profilaxis primaria mejorar el control de nausea y vomito secundario a quimioterapia con poder emetogénico bajo? |
Can granisetron injection used as primary prophylaxis improve the control of nausea and vomiting with low- emetogenic chemotherapy?
Keat CH, Phua G, Abdul Kassim MS, Poh WK, Sriraman M.
Department of Pharmacy, Sultanah Bahiyah Hospital, Alor Setar, Kedah, Malaysia E-mail : huankeat123@yahoo.com.
Asian Pac J Cancer Prev. 2013;14(1):469-73.
Abstract
Background: The purpose of this study is to examine the risk of uncontrolled chemotherapy-induced nausea and vomiting (CINV) among patients receiving low emetogenic chemotherapy (LEC) with and without granisetron injection as the primary prophylaxis in addition to dexamethasone and metochlopramide. Materials and Methods: This was a single-centre, prospective cohort study. A total of 96 patients receiving LEC (52 with and 42 without granisetron) were randomly selected from the full patient list generated using the e-Hospital Information System (e-His). The rates of complete control (no CINV from days 1 to 5) and complete response (no nausea or vomiting in both acute and delayed phases) were identified through patient diaries which were adapted from the MASCC Antiemesis Tool (MAT). Selected covariates including gender, age, active alcohol consumption, morning sickness and previous chemotherapy history were controlled using the multiple logistic regression analyses. Results: Both groups showed significant difference with LEC regimens (p<0.001). No differences were found in age, gender, ethnic group and other baseline characteristics. The granisetron group indicated a higher complete response rate in acute emesis (adjusted OR: 0.1; 95%CI 0.02-0.85; p=0.034) than did the non-granisetron group. Both groups showed similar complete control and complete response rates for acute nausea, delayed nausea and delayed emesis. Conclusions: Granisetron injection used as the primary prophylaxis in LEC demonstrated limited roles in CINV control. Optimization of the guideline-recommended antiemetic regimens may serve as a less costly alternative to protect patients from uncontrolled acute emesis.
http://www.apocpcontrol.org/paper_file/issue_abs/Volume14_No1/469-473%2012.15%20Keat%20Huan%20Chan.pdf
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