Gupta Pushplata, Jain Shilpi
Senior Consultant Anesthesia, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, Rajasthan, India.
Senior Resident Anesthesia, MBS Hospital, Nayapura, Kota, Rajasthan, India.
Saudi J Anaesth. 2014 Nov;8(Suppl 1):S67-71. doi: 10.4103/1658-354X.144081.
Post-operative nausea and vomiting (PONV) is commonly seen after modified radical mastectomy (MRM). In this randomized double-blind prospective study we compared the efficacy of ondansetron, granisetron and granisetron and dexamethasone combination for prevention of PONV following MRM in female patients.
A total of 75 patients (20-60 years of age) undergoing elective MRM were randomly allocated to one of the three groups of 25 patients each. Group O received ondansetron 4 mg, Group G received granisetron 40 mcg/kg and group granisetron and dexamethasone (G + D) received granisetron 40 mcg/kg + dexamethasone 8 mg prior to induction. All episodes of PONV within 24 h after induction of anesthesia were recorded.
Statistical analysis was done using Kruskal-Wallis test (nonparametric ANOVA).
The incidence of complete response (no PONV, no rescue medication) was 96% with G+D, as compared with 86% with granisetron and 4% with ondansetron during 0-3h after surgery which was clinically significant (P < 0.05). Similarly clinically significant response was seen during 3-6, 6-9, 9-12 and 12-24 h of surgery.
Granisetron and dexamethasone combination is more effective for prevention of PONV in comparison to individual ondansetron and granisetron in MRM.
改良根治性乳房切除术（MRM）后常见术后恶心呕吐（PONV）。在这项随机双盲前瞻性研究中，我们比较了昂丹司琼、格拉司琼以及格拉司琼与地塞米松联合用药对女性患者MRM术后预防PONV的疗效。
总共75例（年龄20 - 60岁）接受择期MRM的患者被随机分为三组，每组25例。O组术前接受4 mg昂丹司琼，G组接受40 mcg/kg格拉司琼，格拉司琼与地塞米松联合组（G + D）术前接受40 mcg/kg格拉司琼 + 8 mg地塞米松。记录麻醉诱导后24小时内所有PONV发作情况。
采用Kruskal - Wallis检验（非参数方差分析）进行统计分析。
术后0 - 3小时，G + D组完全缓解（无PONV，无补救用药）发生率为96%，格拉司琼组为86%，昂丹司琼组为4%，具有临床显著性差异（P < 0.05）。在手术3 - 6小时、6 - 9小时、9 - 12小时和12 - 24小时也观察到类似的具有临床显著性的反应。
与单独使用昂丹司琼和格拉司琼相比，格拉司琼与地塞米松联合用药在预防MRM术后PONV方面更有效。
