Comparative study of granisetron and ondansetron alone and their combination with dexamethasone, for prevention of PONV in middle ear surgery

: Our study focuses on post-operative nausea and vomiting (PONV) in middle ear surgery, a horrible experience to both doctors and patients. We compared the efficacy of granisetron and ondansetron alone and their combination with dexamethasone, for prevention of PONV in middle ear surgery. Methods: 125 patients (63 females, 62 males) with a age group between 10 to 60 years , who underwent middle ear surgery were randomly allocated and divided into 5 groups (25 patients in each group) according to the drug they receive i.e, Group-A (control group-no antiemetic), Group-B (granisetron 40mcg/kg), Group-C (granisetron 40mcg/kg + dexamethasone 8mg), Group-D (ondansetron .1mg/kg), Group-E (ondansetron .1mg/kg+ dexamethasone 8mg). After a standard protocol used in all of them, all the groups were evaluated for post-operative nausea , retching and vomiting and their side effects immediately at extubation for 24 hours of anesthesia. Results: The incidence of PONV is different in all groups i.e., maximum in group A (76%) followed by group D (28%), then group B (16%),then group E (12%) and minimum in group C (8%) and statistically significant (p <.001). The incidence of PONV was maximum during first 6 hours, but group B & group C showed higher incidence during first 12 hours whereas group D showed higher incidence during late postoperative period. Conclusion: Prophylactic combination antiemetic therapy of granisetron (40mcg/kg) dexamethasone (8mg) was found to be superior to individual therapy of granisetron and ondansetron and combination therapy of ondansetron (.1mg/kg) and dexamethasone (8mg) in middle ear surgery