Comparison between ondansetron and granisetron in preventing nausea and vomiting after laparoscopic cholecystectomy: A systematic review and meta-analysis.

OBJECTIVES

To find the most optimal drug for post-operative nausea and vomiting (PONV) prophylaxis after laparoscopic cholecystectomy (LC) by comparing ondansetron and granisetron.

METHODS

We carried out our study in adherence to the Preferred Reporting Items for Systematic reviews and Meta-Analyses instructions. Google Scholar, PubMed, Web of Science, and Ovid MEDLINE (through November 2024) were searched for studies comparing ondansetron and granisetron after LC. Primary outcomes include the incidence of PONV at 0-12 hour and 0-24 hour time points; secondary outcomes included rescue anti-emetic use and adverse effects. All data analysis and the quality assessment were carried out by utilizing review manager 5.4.

RESULTS

A total of 21 studies encompassing 1539 patients were included; 17 of them were eligible for meta-analysis. Compared with ondansetron, granisetron was effective in reducing nausea (15.2% vs. 25.4%; risk ratio [RR]=1.67, I2=7%, p=0.0001) and vomiting (10.3% vs. 18%; RR=1.73, I2=49%, p=0.001) within the first 12 hours. At 24-hour time point, granisetron was once again superior in reducing the episodes of nausea (21.8% vs. 38.5%, I2=35%) and vomiting (13.4% vs. 23.3%, I2=52%), with low-to-moderate heterogeneity. Patients on granisetron required less rescue anti-emetics (10.7% vs. 23.1%; RR=2.14, I2=32%, p<0.0001). Adverse effects were also fewer with granisetron (p=0.04).

CONCLUSION

According to our findings, granisetron was superior in preventing PONV when compared to ondansetron following LC, with fewer rescue anti-emetics and adverse effects. Further research on cost-effectiveness and optimal dosing is required.PROSPERO No. ID: CRD42024623780.