A Comparative Study of Dexamethasone, Granisetron and Metoclopramide for Prevention of Nausea and Vomiting after Cataract Surgery

To compare the efficacy of granisetron, metoclopramide and dexamethasone in prevention of post operative nausea and vomiting (PONV) after cataract surgery. Sixty patients scheduled for cataract surgery with age between 45 to 80 years and with ASA class I & II were enrolled in this clinical trial. The patients were randomly allocated to three 20- person groups. The induction of anesthesia in all groups was similar using the same drugs. Granisetron 1 mg IV was administered to patients in the first group and metoclopramide 0.2 mg/kg/IV (Max: 10 mg) was administered to the second group at the end of the surgery. In the third group dexamethasone 0.15 mg/kg/IV (Max: 8 mg) was used before surgery. Patients in all three groups were observed for PONV at defined intervals for 24 hours. Incidence of PONV during first 6 hours after surgery was 5% in granisetron group, 35% in metoclopramide group and 15% in dexamethasone group. Only the difference between granisetron and metoclopramide groups was statistically significant (P= 0.01). Incidence of late PONV (6-24 h) was 5% in granisetron group, 30% in metoclopramide group and zero in dexamethasone group. This difference was statistically significant (P<0.01). Granisetron is more effective than metoclopramide in prevention of PONV after cataract surgery. Granisetron and dexamethasone are more effective than metoclopramide in prevention of late PONV after cataract surgery.