Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jan;29(1):61-5.
doi: 10.4103/0970-9185.105800.

A prospective, randomized, double blind and placebo-control study comparing the additive effect of oral midazolam and clonidine for postoperative nausea and vomiting prophylaxis in granisetron premedicated patients undergoing laparoscopic cholecystecomy

Ghanshyam Yadav  1 , Biranchi Narayan Pratihary, Gaurav Jain, Anil Kumar Paswan, Lal Dhar Mishra
Affiliations

A prospective, randomized, double blind and placebo-control study comparing the additive effect of oral midazolam and clonidine for postoperative nausea and vomiting prophylaxis in granisetron premedicated patients undergoing laparoscopic cholecystecomy

Ghanshyam Yadav et al. J Anaesthesiol Clin Pharmacol. 2013 Jan.

Abstract

Background: Reduction of postoperative nausea and vomiting (PONV) continues to be a major challenge in perioperative care in spite of introduction of newer antiemetics with better efficacy and safety profiles. Therefore, we evaluated the additive effect of oral midazolam and clonidine for PONV prophylaxis in granisetron premedicated patients undergoing laparoscopic cholecystectomy.

Materials and methods: In a prospective, randomized fashion, 120 selected cases were randomized into three groups: I, II or III to receive a tablet of midazolam (15 mg, n = 36), clonidine (150 mcg, n = 40), or glucose as placebo (5 g, n = 44) orally, 1 h before anesthesia. Occurrence of PONV along with need for rescue antiemetic during the first postoperative day was compared between groups as a primary outcome.

Results: Episodes of PONV reduced significantly in Group II (15%) as compared to group I and III (22.2%, 59%) at various time points during the period of observation (P = 0.002). Need for rescue antiemetic was significantly lower in group I (13.88%) and II (5%) as compared to group III (52.27%, P < 0.001).

Conclusion: Oral clonidine is better adjuvant for PONV prophylaxis, as compared to midazolam, in granisetron premedicated patients undergoing laparoscopic cholecystectomy.

Keywords: Clonidine; PONV prophylaxis; granisetron premedicated; midazolam.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 5
Figure 5
Flow chart of patient studied
Figure 1
Figure 1
Mean pulse rate at various time points during postoperative period
Figure 2
Figure 2
Mean systolic blood pressure at various time points during postoperative period
Figure 3
Figure 3
Visual analogue score at various time points during postoperative period
Figure 4
Figure 4
Showing mean Ramsay sedation score (RSS) in Group III at preoperative period was lower as compared to Group I and II
See this image and copyright information in PMC

References

    1. Boehler M, Mitterschiffthaler G, Schlager A. Korean hand acupressure reduces postoperative nausea and vomiting after gynecological laparoscopic surgery. Anesth Analg. 2002;94:872–5. - PubMed
    1. Apfel CC, Laara E, Koivuranta M. A simplified risk scores for predicting postoperative nausea and vomiting. Anesthesiology. 1999;91:693–700. - PubMed
    1. Scuderi PE, James RL, Harris L, Mims GR., III Multimodal antiemetic management prevents early postoperative vomiting after outpatient laparoscopy. Anesth Analg. 2000;91:1408–14. - PubMed
    1. Mikawa K, Nishina K, Maekawa N, Asano M, Obara H. Oral clonidine premedication reduces vomiting in children after strabismus surgery. Can J Anaesth. 1995;42:977–81. - PubMed
    1. Paxton DL, McKay CA, Mirakin KR. Prevention of nausea and vomiting after day care gynaecological laparoscopy. Anaesthesia. 1995;501:403–6. - PubMed