title: Granisetron versus ondansetron for post-operative nausea and vomiting prophylaxis in elective craniotomies for brain tumors: A randomized controlled double-blind study.
abstract: BACKGROUND
  Post-operative nausea and vomiting (PONV) pose unique challenges in neurosurgical patients that warrant its study separate from other surgical groups.
  
  
  METHODS
  This prospective, randomized, double-blind study was carried out to compare and to evaluate the efficacy and safety of three antiemetic combinations for PONV prophylaxis following craniotomy.
  
  
  METHODS
  A total of 75 anesthesiologist status I/II patients undergoing elective craniotomy for brain tumors were randomized into three groups, G, O and D, to receive single doses of dexamethasone 8 mg at induction with either granisetron 1 mg, ondansetron 4 mg or normal saline 2 ml at the time of dural closure respectively. Episodes of nausea, retching, vomiting and number of rescue antiemetic (RAE) were noted for 48 h post-operatively.
  
  
  METHODS
  Analysis of variance with post-hoc significance and Chi-square test with fisher exact correction were used for statistical analysis. P <0.05 was considered to be significant and P < 0.001 as highly significant.
  
  
  RESULTS
  We found that the incidence and number of vomiting episodes and RAE required were significantly low in Group G and O compared with Group D; P < 0.05. However, incidence of nausea and retching were comparable among all groups. The anti-nausea and anti-retching efficacy of all the three groups was comparable.
  
  
  CONCLUSIONS
  Single dose administration of granisetron 1 mg or ondansetron 4 mg at the time of dural closure with dexamethasone 8 mg provide an effective and superior prophylaxis against vomiting compared with dexamethasone alone without interfering with post-operative recovery and neurocognitive monitoring and hence important in post-operative neurosurgical care.
authors.affiliation: Chacha Nehru Bal Chikitsalya, Vardhaman Mahavir Medical College and Safdarjung Hospital, Saket, New Delhi, India.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Gupta
authors.affiliation: Department of Anaesthesia and Intensive Care, Vardhaman Mahavir Medical College and Safdarjung Hospital, Saket, New Delhi, India.
authors.forename: Nikki
authors.initials: N
authors.lastname: Sabharwal
authors.affiliation: Department of Anaesthesia and Intensive Care, Vardhaman Mahavir Medical College and Safdarjung Hospital, Saket, New Delhi, India.
authors.forename: Suniti
authors.initials: S
authors.lastname: Kale
authors.affiliation: Max Super Speciality Hospital, Saket, New Delhi, India.
authors.forename: Mayank
authors.initials: M
authors.lastname: Gupta
authors.affiliation: Department of Anaesthesia and Intensive Care, Vardhaman Mahavir Medical College and Safdarjung Hospital, Saket, New Delhi, India.
authors.forename: Anoop R
authors.initials: AR
authors.lastname: Gogia
keywords: 5HT3 antagonists; craniotomy; dexamethasone; granisetron; neurosurgical; ondansetron; post-operative nausea and vomiting