Comparative Study among Gabapentin, Midazolam and Granisetron for Prevention of Postoperative Nausea and Vomiting after Middle Ear Surgery

Al-Najjar, Ahmed Mohamed Salama; Soud, Dalal El-Sayed Mohammad; Hassan, Haitham Nuri Farg; Mohammed, Nermeen Mohammad Ali

doi:10.21608/ejhm.2022.246918

Comparative Study among Gabapentin, Midazolam and Granisetron for Prevention of Postoperative Nausea and Vomiting after Middle Ear Surgery

Document Type : Original Article

Authors

10.21608/ejhm.2022.246918

Abstract

Background: Postoperative nausea and vomiting (PONV) is the one of the most unpleasant complications. PONV is more distressing for patients than pain.
Objective: The aim of the present study was to prevent PONV after middle ear surgery by comparing one hour preinduction use of oral gabapentin, intravenous Midazolam or Granisetron.
Patients and methods: This was a prospective double-blinded randomized placebo controlled clinical study that was conducted in Anesthesia, Intensive Care and Pain Management Department in Zagazig University Hospitals. The study was carried out within 6 months on 108 adult patients between the ages of 21 and 65 years planned for middle ear surgery. The study included 46 men and 62 women. The patients were divided into four groups: Control (C) group, Gabapentin (G) group, Midazolam (M) group and Granisetron (GR) group (27 patients in each). Patients were followed-up 24 hours postoperatively for the incidence and severity of PONV, hemodynamic changes, side effects of these drugs and the need for rescue antiemetics.
Results: Vomiting and nausea was considerably higher in Group C. Moreover, nausea was noticeably associated with Group G, It was reduced from 14.3% at 8-16 hr interval to 9.5% at 16-24 hr interval in M group. There was no significant difference among studied groups regarding side effects. Only one patient in G group felt dizziness, one patient suffered from extra pyramidal symptoms and one patient complained from vertigo. One patient in C group felt vertigo and 2 patients in GR group felt headache.
Conclusions: Using oral Gabapentin 300 mg, intravenous Midazolam 0.075 mg/kg or Granisetron 3 mg one hour before induction of anesthesia in middle ear surgeries, surely causes a substantial reduction in occurrence of PONV.

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