COMPARATIVE EVALUATION OF EFFICACY OF ONDANSETRON, GRANISETRON AND RAMOSETRON FOR PREVENTION OF NAUSEA AND VOMITING IN PATIENTS UNDERGOING CAESAREAN SECTION

Background: Ramosetron is a new selective 5-hydroxytryptamine type 3 (5-HT3) receptor antagonist that reportedly has more potent antiemetic effects compared with other 5-HT3 receptor antagonists. The purpose of this study was to compare the efficacy of Ramosetron with Ondansetron and Granisetron for the prevention of nausea and vomiting in patients undergoing caesarean section. Method: In this prospective, randomized, double blind study, we have compared Ondansetron, Granisetron and Ramosetron for prevention of nausea and vomiting in patients undergoing elective caesarean section. 150 patients were divided into three groups: Group O (Ondansetron 4 mg), Group G (Granisetron 3 mg) and Group R ( Ramosetron 0.3 mg). Incidence and severity of nausea and vomiting, use of rescue antiemetic and side effects and complications were evaluated during and upto 24 hrs after surgery. Result: Complete response was maximum in group R (96%) and similar in group O and G (94%) during intraoperative period. It was observed in 80% patients in group O and 86% and 94% patients in group G and R respectively in early post operative period (0-6 hrs). The corresponding incidence in late post operative period (6-24 hrs) was 66%, 80% and 90% in group O, G and R respectively. No serious adverse effects were observed in any group. Conclusion: Ramosetron followed by Granisetron is comparably better than Ondansetron for prophylaxis of nausea and vomiting during and after caesarean section.