To Compare the Effectiveness of Granisetron Versus Ondansetron to Control Nausea and Vomiting During Lower Segment Cesarean Section Under Subarachnoid Block

Background

Nausea and vomiting (NV) seen during and after lower segment cesarean section (LSCS) are due to increased intragastric pressure, hypotension, stretching the peritoneum (exteriorization of the uterus), excessive surgical manipulation and visceral stimulation, using opioids, using uterotonic agents, and the patient's mental status. Ondansetron and granisetron intravenous (i.v.) are useful for avoiding bradycardia and hypotension.

Objectives

The objective of this study is to study the effectiveness of granisetron versus ondansetron to control NV during LSCS under subarachnoid block.

Materials and Methods

Eighty patients undergoing elective cesarean section under spinal anesthesia by intrathecal bupivacaine were randomly divided into two groups (40 pregnant females of the American Society of Anesthesiologists physical status Classes I and II in each Group). Group 1 received granisetron 40 mg.kg-1 i.v. stat after clamping the cord and Group 2 given i.v. ondansetron 8 mg stat after clamping the cord. NV were observed at the "early postoperative period (0-3 h)" and "late postoperative period (4-24 h)."

Statistical Analysis Used

Student's t-test and Chi-square test were used to find out the statistical significance, P < 0.05 was considered statistically significant.

Results

The mean age was 29.3 years with 4.15 standard deviation (SD) and 28.3 years with 4.41 SD in Groups 1 and 2, respectively. The mean duration of surgery was 53.1 min with 6.67 min SD and 57.7 min with 10.26 SD in Groups 1 and 2, respectively. In the "early postoperative period," NV observed in 7.5% and 10.0% participants in Groups 1 and 2, respectively (P > 0.05), and in "late postoperative period," NV observed in 0.0% and 22.5% participants in Groups 1 and 2, respectively (P < 0.05).

Conclusion

Granisetron reduces the severity of spinal-induced hypotension, need for rescue vasopressor, and incidence of nausea.

Small intestinal adenocarcinoma in Peutz-Jeghers syndrome

Peutz-Jeghers syndrome (PJS) is characterized by intestinal hamartomatous polyposis (usually affecting the jejunum) and mucocutaneous melanin spots. Though malignant changes are not common, PJS can predispose to carcinoma in the GI tract and elsewhere. We report a 25-year-old man with PJS who developed small intestinal adenocarcinoma and presented with small bowel obstruction due to jejuno-ileal intussusception.