European Journal of Molecular & Clinical Medicine

Postoperative nausea and vomiting is (PONV) a very distressing complication and preventive measures are justified when the risk of PONV is very high. Ondansetron is the first 5-HT3 antagonist used alone or in combination for prophylaxis of PONV due to its lower cost. Granisetron is recently introduced 5-HT3 antagonists with greater affinity for 5-HT3 receptor and having longer half-life. Aim of the present study is to compare the antiemetic efficacy of ondansetron, granisetron in high-risk patients undergoing laparoscopic cholecystectomy under general anaesthesia. Method: This study was prospective and randomized one. Written informed consent will be taken from patients in both groups. Patients will be kept NPO for 12 hours before surgery. In the preoperative room, iv line will secured. In the operation theatre ASA Standard monitoring devices pulse oximetry, NIBP, ECG will be attached and baseline blood pressure, heart rate and O2 saturation values will be recorded. Later capnograpy will be attached after the intubation.

Background: The goal of PONV management is to reduce or eliminate PONV and discomfort with minimum side effects. 5-HT antagonists work by blocking one of the pathways that lead to vomiting. Ondansetron is the most commonly used drug for this purpose. Ramosetron has a higher affinity for the 5-HT3 receptor than the older 5-HT3 antagonists, with an optimal dose of 0.6 mg and maintains its effects over two days.
Objectives: To compare the efficacy of ondansetron and ramosetron in the control of
postoperative nausea and vomiting and to determine the occurrence of adverse effects with ondansetron and ramosetron.
Material and Methods: Fifty patients aged between 20-60 years posted for lower abdominal surgeries were divided into two groups (Group A & Group B) on the basis of the random sampling method. Group A received the first dose of Ramosetron in the intraoperative period 30min-1 hour before expected end of surgery. Group B received the first dose of Ondansetron in the intraoperative period 30min-1 hour before the expected end of surgery. Both groups were postoperatively monitored for incidence of nausea, the severity of nausea, the incidence of vomiting and use of rescue antiemetics, for 24 hours.
Data Analysis: The mean and Standard Deviation (SD) in each group was calculated. The data were analyzed by student t-test. For qualitative data, Chi-Square test was used for analysis. P-value less than 0.05 was considered statistically significant.
Result: The present results revealed that ramosetron is more effective than ondansetron in preventing late postoperative nausea and vomiting. Ramosetron is more potent and longer acting as compared to ondansetron. Incidences of side effects and use of rescue antiemetic are statistically not significant in both the groups.
Conclusion: This study concludes that the prophylactic intravenous administration of
ramosetron is more effective than ondansetron for controlling late postoperative nausea and vomiting.

Background: The aim of this study is to evaluate the per se effect of cinnamaldehyde which
is obtained from bark oil of cinnamon tree and its interaction with ondansetron on catalepsy
in Swiss albino mice.
Methods: Haloperidol induced catalepsy model was used. A group of 36 healthy mice of
either sex weighing 20-30 grams were divided at random into six groups (n=6).
Cinnamaldehyde with 98 percent purity was obtained. Catalepsy was induced by haloperidol
(1mg/kg, i.p). Control group received tween-20 20% (10ml/kg, p.o), standard groups were
administered ondansetron (0.5mg/kg and 1mg/kg, p.o ), test groups received cinnamaldehyde
in strength of 100mg/kg, and 200mg/kg and combination group of ondansetron plus
cinnamaldehyde (0.5mg/kg + 100mg/kg) per oral, respectively.
Results: In this acute study, from 60 min onwards after haloperidol administration,
ondansetron at both doses (0.5 mg/kg and 1 mg/kg), showed significantly lower cataleptic
scores as compared to all groups. Cinnamaldehyde at both strengths did not show any
significant effect as compare to control at any point of time (P>0.05). Combination of
ondansetron 0.5 mg/kg with cinnamaldehyde 100mg/kg, showed significant increase in
cataleptic score as compared to ondansetron 0.5 and 1mg/kg alone (P>0.05). Which suggest
that cinnamaldehyde abolishes the protective effect of ondansetron in haloperidol induced
catalepsy.

Introduction: Spinal anaesthesia is simple, rapid and most reliable anaesthetic technique. It is the most common regional anaesthesia technique, practiced worldwide. It is an efficient technique, which is easy to perform. However, associated with side effects like hypotension, bradycardia and also post-operative nausea, vomiting and chills. Decrease in vascular resistance caused by sympathetic blockade leads to drop in arterial pressure. Bradycardia is caused due to parasympathetic over activity, increase in baroreceptor activity and Bezold Jarish reflex (BJR). Ondansetron is a well-tolerated drug with 5HT3 antagonising effects which is used most commonly for peri-operative nausea and vomiting with minor side effects. Ondansetron poorly penetrates the blood brain barrier with minimal influence on central serotogenic mechanisms. Hence has less chances of causing cognitive side effects like headache, agitation and confusion. The objectives of this study is to assess the effect of intravenous ondansetron on spinal anaesthesia induced hypotension and bradycardia and the effect of ondansetron on Peri-operative nausea, vomiting and chills.

Background: The use of anesthetics and opioids leads to motor and behavioral
inhibition, body movements and consequently a decrease in body temperature, which
results in shivering. So, the objective of this study to evaluate the efficacy Of Ketamine
and Ondansetron for prevention of shivering during anesthesia.
Materials and Methods: Total 120 cases were included in this study. We were divided in
to 2 groups. This study was conducted in the Department of Anaesthesia in Pacific
Medical College and Hospital.
Results: We were included 120 cases in this study. Among all 70 were female and rest
were male. We were divided in to three group which were Ketamine (60) &
Ondansetron (60). We were found in this study, the frequency of shivering in the groups
who received Ketamine was significantly lower than the Ondansetron group.
Conclusion: This study concludes that, Ketamine in dose of 0.25mg/kg has been found
to be significantly more effective than ondansetron (4mg) during spinal anesthesia.

Background:Spinal anesthesia is a common choice for patients undergoing orthopedic
surgeries.ondansetron was found to attenuate the incidence of SIH and bradycardia during
spinal anesthesia.
Aim of the study:This work was done to compare between the effects of prophylactic
intravenous of two different doses of ondansetron (4 mg) and (8 mg) in attenuating hypotension
in patients undergoing orthopedic surgeries under spinal anesthesia.
Patients and methods:This study wasa prospective comparative randomized controlled clinical
trial that have been carried out in Zagazig University Hospitals and included 66 patients, their
ages ranged from 21 to 60 years old patients for only unilateral orthopedic surgeries under
spinal anesthesia, duration of surgery less than 2 hours in the study.Patients were randomly
divided into three equal groups, 22 patients for each group, Group "O1" received IV
ondansetron (4mg) diluted in 10 ml saline, group "O2" received IV ondansetron (8mg) diluted
in 10 ml saline, and group C (control) received only 10 ml IV saline alone. Medications were
administrated 5 min before starting the subarachnoid block by an anesthesiologist blinded to
them, they were assessed for their cardiovascular effects including blood pressure, heart rate
(HR) before, throughout and after operation.
Results:There was difference between the prophylactic intra venous of the two different doses
of ondansetron in attenuating hypotension in patients undergoing orthopedic surgeries, under
spinal anesthesia compared with the control group. Mean Blood Pressure (MBP) and HR were
significantly, lower among the control group from 5 min tell the 10 minutes compared to (O1)
and (O2) groups.
Conclusion:
In patient undergoing orthopedic surgeries under spinal anesthesia, prophylactic intravenous
administration of 4mg ondansetron or 8mg ondansetron 5min before induction of spinal
anesthesia to reduce the severity of spinal-induced hypotension and bradycardia well
significantly.