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Background: Nausea and vomiting during awake craniotomy (AC) can increase cerebral pressure and cause asphyxia and aspiration. 5-HT3 receptor antagonists, such as granisetron, are often administered before awakening to prevent nausea during AC. Recently, dexamethasone was reported to prevent nausea and vomiting during AC; however, the efficacy of both drugs in preventing nausea has not yet been investigated. Methods: We examined the frequency of nausea and vomiting in AC patients (n = 170) treated at our hospital until the end of September 2019. We divided patients as those who received dexamethasone (n = 71) and or granisetron (n = 99) before awakening and examined the frequency of nausea and vomiting after propensity score (PS) matching. Result: Eighty-two patients were selected after PS matching. The incidence of nausea was significantly lower in the dexamethasone group than in the granisetron group (9.8% vs 41.5%, p = 0.002). In the logistic regression analysis after matching, the incidence of nausea significantly reduced with dexamethasone treatment (odds ratio: 0.12, 95% confidence interval: 0.029–0.499, p = 0.03). Conclusion: In conclusion, dexamethasone was more effective than granisetron in preventing nausea during AC. [ABSTRACT FROM AUTHOR]

Background: Post-operative shivering after spinal anesthesia is a common issue in women undergoing cesarean section, then its management is necessary to increase patients’ satisfaction. Therefore, the current study aimed to compare the prophylactic effect of Granisetron and meperidine on post-spinal shivering in elective cesarean section. Methods: In this double-blinded clinical trial study, 100 women under elective cesarean section using block randomization were divided into two groups. The spinal anesthesia was performed in all women with 10 mg hyperbaric bupivacaine 0.5 %. Then, after the birth of the baby, the patients received 0.04 mg/kg Granisetron or 0.4 mg/kg meperidine intravenously. Mean Arterial Pressure (MAP), Heart Rate (HR), and percentage of arterial blood oxygen saturation (SpO2 ) were measured before intervention and 60 minutes after surgery using a standard monitoring device. Shivering was evaluated 30 minutes after the surgery in the recovery room according to the clinical examinations. Results: The changes in hemodynamics parameters were similar between the two groups. There was a statistically significant difference in the rate of shivering between the two groups. The rate of shivering in the Granisetron group was higher than in the meperidine group. Thus, 13 patients (26%) and 5 patients (10%) had shivering in the Granisetron and meperidine groups, respectively (p=0.037). Conclusion: Granisetron was not more effective than meperidine as routine treatment in preventing shivering after spinal anesthesia in women under elective cesarean section. [ABSTRACT FROM AUTHOR]

Abstract Background Nausea and vomiting during awake craniotomy (AC) can increase cerebral pressure and cause asphyxia and aspiration. 5-HT3 receptor antagonists, such as granisetron, are often administered before awakening to prevent nausea during AC. Recently, dexamethasone was reported to prevent nausea and vomiting during AC; however, the efficacy of both drugs in preventing nausea has not yet been investigated. Methods We examined the frequency of nausea and vomiting in AC patients (n = 170) treated at our hospital until the end of September 2019. We divided patients as those who received dexamethasone (n = 71) and or granisetron (n = 99) before awakening and examined the frequency of nausea and vomiting after propensity score (PS) matching. Result Eighty-two patients were selected after PS matching. The incidence of nausea was significantly lower in the dexamethasone group than in the granisetron group (9.8% vs 41.5%, p = 0.002). In the logistic regression analysis after matching, the incidence of nausea significantly reduced with dexamethasone treatment (odds ratio: 0.12, 95% confidence interval: 0.029–0.499, p = 0.03). Conclusion In conclusion, dexamethasone was more effective than granisetron in preventing nausea during AC.

INTRODUCTION: Postoperative nausea and vomiting (PONV), a common and uncomfortable consequence of anaesthesia and surgery, can lead to dehydration, alkalosis, aspiration, and psychological distress, including a reluctance to undergo future surgical procedures. The aim of the study was to compare the effect of Granisetron and Palonosetron on the prevention of postoperative nausea and vomiting in patients undergoing laparoscopic surgery under general anaesthesia. MATERIALS AND METHODS: In this randomised prospective study, after a full preoperative evaluation and investigation, patients meeting the inclusion criteria were taken for the study. 80 patients were selected and randomly divided into two groups. Group G received 40 mcg/kg of granisetron and group P was administered palonosetron 1 mcg/kg before induction of anesthesia. The patients were monitored in the postoperative period and PONV scores were observed at 0-2, 4-6, 6-12, and 12-24 hours postoperatively. Rescue antiemetic, in the form of Dexamethasone 4 mg IV, was administered with PONV score 0.05). During the 6- to 12-hour interval and the 12- to 24-hour interval, PONV scores were significantly lower in patients in Group P (p-value 0.022). There was no statistically significant difference between the antiemetic rescue requirement between the group G and group P (p-value 0.152). CONCLUSIONS: This study concludes that both granisetron and palonosetron are effective in controlling PONV in the immediate postoperative period, but palonosetron is superior to granisetron in preventing PONV beyond 6 hours.

Abstract Objective To evaluate the safety and efficacy of the granisetron transdermal delivery system (GTDS) combined with Dexamethasone for preventing chemotherapy-induced nausea and vomiting (CINV) in patients receiving Capecitabine plus Oxaliplatin (CapeOX) therapy. Design Open-label, prospective, multi-center phase II trial. Setting Three institutions. Participants Fifty-four patients scheduled to receive CapeOX chemotherapy. Interventions Participants received GTDS (3.1 mg applied to the upper arm 48 h before chemotherapy, replaced on day 5, and discarded on day 12) and Dexamethasone. Main outcome measures The primary endpoint was the complete control rate of CINV. Secondary endpoints included the duration of delayed complete control, complete control rate in the acute phase, safety, and quality of life. Results The complete control rate for delayed CINV over the entire period (25–480 h) was 72.7% (95% CI 0.57–0.88). The duration of delayed complete control was 17.2 ± 4.5 days, with 51.5% of patients experiencing no nausea during the delayed phase. The complete control rate in the acute phase was 81.8% (95% CI 0.69–0.95). No serious adverse events related to the antiemetic regimen were reported. Conclusion Prolonged administration of GTDS is safe and effective for preventing CINV in patients with gastrointestinal malignancies treated with CapeOX. Trial Registration ClinicalTrials.gov registry (NCT05325190); registered on October 10, 2021.

INTRODUCTION: Postoperative nausea and vomiting (PONV), a common and uncomfortable consequence of anaesthesia and surgery, can lead to dehydration, alkalosis, aspiration, and psychological distress, including a reluctance to undergo future surgical procedures. The aim of the study was to compare the effect of Granisetron and Palonosetron on the prevention of postoperative nausea and vomiting in patients undergoing laparoscopic surgery under general anaesthesia. MATERIALS AND METHODS: In this randomised prospective study, after a full preoperative evaluation and investigation, patients meeting the inclusion criteria were taken for the study. 80 patients were selected and randomly divided into two groups. Group G received 40 mcg/kg of granisetron and group P was administered palonosetron 1 mcg/kg before induction of anesthesia. The patients were monitored in the postoperative period and PONV scores were observed at 0-2, 4-6, 6-12, and 12-24 hours postoperatively. Rescue antiemetic, in the form of Dexamethasone 4 mg IV, was administered with PONV score <1. RESULTS: There were no statistically significant differences between the two groups with respect to the classification of ASA, the sex distribution, age, BMI or the duration of anaesthesia, making the two groups comparable. PONV scores were comparable between the two groups during 0 to 2 hours and 2 to 6 hours postoperatively (p value>0.05). During the 6- to 12-hour interval and the 12- to 24-hour interval, PONV scores were significantly lower in patients in Group P (p-value 0.022). There was no statistically significant difference between the antiemetic rescue requirement between the group G and group P (p-value 0.152). CONCLUSIONS: This study concludes that both granisetron and palonosetron are effective in controlling PONV in the immediate postoperative period, but palonosetron is superior to granisetron in preventing PONV beyond 6 hours. [ABSTRACT FROM AUTHOR]

Background: Spinal anesthesia often causes more post-operative nausea and vomiting (PONV). Cesarean-section patients have a significantly more PONV rate. Therefore, evidence-based knowledge about PONV prevention and care for high-risk individuals is urgently needed to reduce the consequences. Aims and Objectives: The aim of the study was to compare the efficacy and safety of granisetron with that of ondansetron in the prevention of PONV in patients undergoing cesarean section under spinal anesthesia. Materials and Methods: A total of 86 pregnant women with American Society of Anesthesiologists grade I–II scheduled for cesarean delivery under spinal anesthesia were enrolled. Patients were divided into two equal groups (n=43): Ten minutes before spinal anesthesia, patients in group B (granisetron) received 2 mg granisetron intravenously diluted to 10 mL with normal saline, whereas patients in group A (ondansetron) received 4 mg ondansetron. Results: There was no significant difference between Groups A and B in terms of the number of vomiting episodes between 0 and 6 h. Group A had significantly more episodes of nausea after 2 h than Group B after 0–2 h. After 2–6 h, however, the nausea was similar in all groups. Of the patients in Group A, 4 (9.3%) required antiemetic medication, in Group B, it was 2 (4.7%). In Group A, 8 patients (18.6%) and 6 patients (14%) complained of headache and dizziness, respectively; in Group B, 3 patients (7.0%) and (0%), respectively. Dizziness was significantly more pronounced in Group A than in Group B. Conclusion: The results of the study show that granisetron (2 mg) was more effective than ondansetron (4 mg) in minimizing PONV episodes in women undergoing spinal anesthesia for cesarean section. There were no significant side effects and both drugs were comparatively safe.

Background: Spinal anesthesia often causes more post-operative nausea and vomiting (PONV). Cesarean-section patients have a significantly more PONV rate. Therefore, evidence-based knowledge about PONV prevention and care for high-risk individuals is urgently needed to reduce the consequences. Aims and Objectives: The aim of the study was to compare the efficacy and safety of granisetron with that of ondansetron in the prevention of PONV in patients undergoing cesarean section under spinal anesthesia. Materials and Methods: A total of 86 pregnant women with American Society of Anesthesiologists grade I-II scheduled for cesarean delivery under spinal anesthesia were enrolled. Patients were divided into two equal groups (n=43): Ten minutes before spinal anesthesia, patients in group B (granisetron) received 2 mg granisetron intravenously diluted to 10 mL with normal saline, whereas patients in group A (ondansetron) received 4 mg ondansetron. Results: There was no significant difference between Groups A and B in terms of the number of vomiting episodes between 0 and 6 h. Group A had significantly more episodes of nausea after 2 h than Group B after 0-2 h. After 2-6 h, however, the nausea was similar in all groups. Of the patients in Group A, 4 (9.3%) required antiemetic medication, in Group B, it was 2 (4.7%). In Group A, 8 patients (18.6%) and 6 patients (14%) complained of headache and dizziness, respectively; in Group B, 3 patients (7.0%) and (0%), respectively. Dizziness was significantly more pronounced in Group A than in Group B. Conclusion: The results of the study show that granisetron (2 mg) was more effective than ondansetron (4 mg) in minimizing PONV episodes in women undergoing spinal anesthesia for cesarean section. There were no significant side effects and both drugs were comparatively safe. [ABSTRACT FROM AUTHOR]

Background: Automatic monitoring and assessment are increasingly employed in drug safety evaluations using hospital information system data. The increasing concern about granisetron-related arrhythmias requires real-world studies to improve our understanding of its safety. Aim: This study aimed to analyze the incidence, clinical characteristics, and risk factors of granisetron-related arrhythmias in hospitalized patients using real-world data obtained from the Adverse Drug Event Active Surveillance and Assessment System-II (ADE-ASAS-II) and concurrently aimed to develop and validate a nomogram to predict the occurrence of arrhythmias. Method: Retrospective automatic monitoring of inpatients using granisetron was conducted in a Chinese hospital from January 1, 2017, to December 31, 2021, to determine the incidence of arrhythmias using ADE-ASAS- II. Propensity score matching was used to balance confounders and analyze clinical characteristics. Based on risk factors identified through logistic regression analysis, a prediction nomogram was established and internally validated using the Bootstrap method. Results: Arrhythmias occurred in 178 of 72,508 cases taking granisetron with an incidence of 0.3%. Independent risk factors for granisetron-related arrhythmias included medication duration, comorbid cardiovascular disease, concomitant use of other 5-hydroxytryptamine 3 receptor antagonists, alanine aminotransferase > 40 U/L, and blood urea nitrogen > 7.5 mmol/L. The nomogram demonstrated good differentiation and calibration, with enhanced clinical benefit observed when the risk threshold ranged from 0.10 to 0.82. Conclusion: The nomogram, based on the five identified independent risk factors, may be valuable in predicting the risk of granisetron-related arrhythmias in the administered population, offering significant clinical applications. [ABSTRACT FROM AUTHOR]

In this study, a rapid, simple and sensitive UPLC-MS/MS method was established for the quantification of granisetron in human plasma for the prevention of vomiting after radiotherapy and chemotherapy. The precipitated proteins were extracted and gradient eluted on a ZORBAX Eclipse Plus C18 column (2.1×50mm, 1.8μm) to achieve ideal chromatographic separation. Multiple reaction mode (MRM) was performed using a Turboion Spray API5500 mass spectrometer equipped with Electron Spray Ionization (ESI). For method validation, good linearity was observed for each analyte of interest in the validation concentration range of 0.05 to 20.0ng/mL. The CV% of inter-batch and intrabatch precision were in the range of -3.6% to 4.7% and the precision of both inter-batch and intra-batch was ≤15.0%. In addition, the method had the advantage of a low matrix effect. In human plasma, all analytes remained stable for 2 hours when kept at room temperature; samples were stable within the autosampler (5°C) for 141 h after preparation and after four freeze-thaw cycles at -20°C and -70°C for 48 days. The UPLC-MS method that had been validated was later utilized for the pharmacokinetic investigation of granisetron hydrochloride tablets in orally administered doses to healthy Chinese volunteers, both before and after meals. [ABSTRACT FROM AUTHOR]

Introduction: Propofol a routinely used intravenous induction agent for general anaesthesia is known to cause pain on injection due to its lipid emulsion property. Various methods have been tried to address propofol induced pain but have produced variable results. Pretreatment with Ondansetron a 5-HT3 antagonist has been shown to alleviate pain on propofol injection. Aim: To compare the efficacy of intravenous granisetron versus a placebo(normal saline) to reduce pain on propofol injection. Materials and Method: This randomised double blinded trial included18-60 year old American Society of Anaesthesiologists Physical Status(ASA PS) I and II patients for elective surgery under general anaesthesia.110 patients were randomly allocated into two groups of 55 each. They received either 2ml granisetron(1mg/ml) or 2ml 0.9 %saline. After receiving the test or control drug, patients were asked to score the pain on a four point categorical scale. Results: Pain in the control group was 92.7% when compared to 10.9% in the intervention group(p < 0.0001). The severityof pain was also less in the intervention group pre-treated by 2ml of granisetron. Conclusion: We found that intravenous Granisetron was effective in reducing pain on propofol injection. [ABSTRACT FROM AUTHOR]

The Cryogenic Underground Observatory for Rare Events (CUORE) at Laboratori Nazionali del Gran Sasso of INFN in Italy is an experiment searching for neutrinoless double beta (0νββ) decay. Its main goal is to investigate this decay in ^{130}Te, but its ton-scale mass and low background make CUORE sensitive to other rare processes as well. In this Letter, we present our first results on the search for 0νββ decay of ^{128}Te, the Te isotope with the second highest natural isotopic abundance. We find no evidence for this decay, and using a Bayesian analysis we set a lower limit on the ^{128}Te 0νββ decay half-life of T_{1/2}>3.6×10^{24}  yr (90% CI). This represents the most stringent limit on the half-life of this isotope, improving by over a factor of 30 the previous direct search results, and exceeding those from geochemical experiments for the first time.

The effects of the 5-hydroxytryptamine (5-HT3) receptor antagonists on regional anaesthesia are complex and unclear. The present study was designed to test the hypothesis that granisetron, a selective 5-HT3 receptor antagonist, would decrease the duration of motor block, sensory block, and proprioception in a dose-dependent fashion in a rat model of bupivacaine-induced sciatic nerve blockade. Thirty-eight male Wistar Albino rats that received unilateral sciatic nerve blocks were randomly divided into five experimental groups. Group B received a perineural of 0.3 ml of bupivacaine alone; Group BG800 received perineural 0.3 ml of bupivacaine and 800 µg of granisetron 10 min later; Group BG1200 received perineural 0.3 ml of bupivacaine and 1200 µg of granisetron 10 min later; Group BG1200IP received a perineural 0.3 ml of bupivacaine and an intraperitoneal injection of 1200 µg of granisetron 10 min later; and Group S was sham operated. A blinded investigator assessed motor, sensory and proprioception function every 10 min until the return of normal function. The medians for recovery times in Group B, Group BG800, Group BG1200, and Group BG1200IP were 105, 64, 85, and 120 min for motor function, respectively; 80, 64, 84, and 104 min for sensory function; 80, 63, 85, and 108 min were calculated for the proprioception function. The time to the return of normal motor, sensory, and proprioception function was not statistically significantly different between the groups (p > 0.05). Motor block did not develop in any of the rats in Group S. Local and systemic application of granisetron was not significantly decrease the duration of bupivacaine induced motor, sensory, and proprioception block of sciatic nerve in rat. [ABSTRACT FROM AUTHOR]

Background: Chemotherapy-induced nausea and vomiting (CINV) is a common and significant problem in children receiving chemotherapy. While 5-HT3 blockers are commonly used antiemetics, there is no consensus about choice among them. This study was planned to look for clinician preference for 5-HT3 blocker agent, clinical efficacy, and need for rescue medicines. Material and methods: The prospective, observational study was conducted in a tertiary care cancer center in Uttarakhand in patients aged 1–18 years. Patients received one of the three 5-HT3 blockers, ondansetron, palonosetron, or granisetron, according to the choice of treating clinician in each chemotherapy cycle. Observations were made for breakthrough CINV, retching episodes, and the need for rescue medication. The assessment was done by the patient and attendants on a self-reporting scale and by the nursing staff based on CTCAE (ver 4.03) criteria. Results: Ondansetron was the most commonly used 5-HT3 blocker; used in 53% of the chemotherapy cycles. All three 5-HT3 blockers evaluated in this study, showed efficacy in preventing acute CINV. However, granisetron was inferior based on the self-reporting scale. The nursing assessment showed better control of acute CINV with palonosetron in terms of grade and number of breakthrough CINV episodes (p

Introduction: This study was performed to evaluate the degree of 3-day chemotherapy-induced nausea and vomiting (CINV) in children with cancer who received highly emetogenic chemotherapy (HEC) to ascertain the efficacy of aprepitant single-dose on dayL 1 plus granisetron and dexamethasone (DEX). Methods: This clinical trial study was conducted on 120 patients in the age range of 5 to 18 years old who received chemotherapy. Patients were divided into two groups; Group A received aprepitant at 125 mg/kg on day 1 orally, followed by 80 mg/kg daily on days 2 and 3 and Group B received a single dose of aprepitant 125 mg/kg on day 1 orally and placebo on days 2 and 3. All groups received granisetron 3 mg/m2 on day 1 and DEX on days 1 to 3. The primary and secondary endpoints were to evaluate the proportion of patients with acute, delayed and overall CINV within each group. Results: There were no significant differences between the two groups for vomiting, nausea or the use of rescue therapy. The number of patients without vomiting on day 1 was similar in both groups (96.5% vs. 98.3%, respectively; p = 0.848). Conclusion: According to the results of this study, a single dose of aprepitant 125 mg/kg was as effective as administering three doses of aprepitant on 3 days. Therefore, the use of a single dose of aprepitant in combination with other standard treatment regimens to prevent CINV in children who received HEC was safe and efficacious and can be beneficial.

Background: Recently, use of HT35 receptor antagonists to prevent postoperative shivering has attracted a great deal of attention. This study was conducted with the aim of investigating the effectiveness of granisetron as an HT35 antagonist when compared with ondansetron and meperidine in preventing postoperative shivering. Material and Methods: In this triple blind random clinical trial study, 90 patients 18-50 years of age with ASA Class I and II undergoing general anesthesia were randomly assigned into one of the three drug groups: O (4-mg ondansetron), G (40 jug/kg of granisetron), and P (25 mg meperidine), immediately before induction of anesthesia. After anesthesia induction, at the end of the surgery, after the entrance and after leaving the recovery state, central temperature, peripheral temperature, heart rate, systolic blood pressure, diastolic blood pressure, and shivering were measured and documented. Two-tailed P < 0.05 was considered significant. Results: In the meperidine, ondansetron, and granisetron groups, 4 (13.3%), 3 (10%), and 10 (33.3%) of patients experienced shivering during recovery, where the difference between the ondansetron and granisetron groups was significant (p-value=0.02). The variations in the mean arterial pressure during the investigation stages only in the ondansetron group were not significant (p>0.05). At the beginning of recovery, the reduction of peripheral temperature significantly was lower in the ondansetron group (p<0.05), while reduction of the central temperature was significantly (p<0.05) higher in the granisetron group. By the end of the recovery, the variations in the peripheral temperature across the three groups were consistent with the changes at the beginning of recovery, but variations of the central temperature across the three groups was not significantly diverse. Conclusion: Granisetron was not found to be much effective in preventing postoperative shivering. Ondansetron and meperidine were equally effective in preventing postoperative shivering. Ondansetron also causes less hemodynamic changes compared to other drugs, while granisetron is more effective in terms of preventing nausea and vomiting. [ABSTRACT FROM AUTHOR]

The authors sought to quantify the clinical impacts of granisetron, ketamine, dexmedetomidine, and lidocaine combined with fentanyl, for procedural sedation and analgesia in cystoscopy and for bladder catheter tolerance. This double-blind trial recruited four stratified blocked randomized eligible groups of patients (n = 120) formerly identified as needing cystoscopy, each receiving one of the above four anesthetic agents. Dexmedetomidine-sedated subjects experienced less pain from 5 to 120 minutes after the beginning of procedure, and next the ketamine manifested a better pain relief experienced. Sedation score was found to be rather more satisfactory in the early-mentioned from 15 to 55 minutes and at 90 and 105 minutes after procedure. The mean opioid use was observed lower in the dexmedetomidine treated patients and next in the ketamine administered patients. Considering the findings emanating from the study and the lack of complications that need to be treated, dexmedetomidine and ketamine afforded superior pain relief, greater sedation, and less postoperative opioid use in patients undergoing cystoscopy, and thus, they could be suggested to be combined with fentanyl during outpatient cystoscopy [ABSTRACT FROM AUTHOR]

Background: Shivering is one of the most common adverse outcomes associated with the administration of spinal anaesthesia, which, when clinically relevant, leads to numerous detrimental effects on the human body. Hence, its management becomes imperative. Meperidine, an opioid analgesic, is the drug of choice for this condition. However, the use of meperidine is controversial, as it carries the devastating adverse effect of respiratory depression. We explored the role of granisetron, a 5HT3 antagonist and a commonly used antiemetic premedication, in minimising the incidence of post-spinal shivering and decreasing the use of meperidine as a rescue drug. Methods: Overall, 160 parturient patients, between the ages 18-50, undergoing uncomplicated, elective caesarean section, were enrolled in the study, and randomized into two groups with 80 participants each: Group A received 3ml of normal saline, and Group B was administered 3 mg granisetron, 15 minutes before spinal anaesthesia institution. Incidence of clinically relevant shivering (score of 3 or more) was noted, and it was recorded whether meperidine was used or not. Results: 67.5% of participants in Group A, and 32.5% of patients in Group B, experienced clinically relevant shivering, with 62.5% of patients in Group A and 28.75% in Group B warranting the use of meperidine. There was a statistically significant difference between the two groups in terms of incidence of clinically relevant shivering, and meperidine consumption (p-value <0.001). Conclusion: Premedication with 3 mg granisetron effectively attenuates the occurrence of post-spinal shivering and, hence, lowers the requirement of meperidine as rescue medication. [ABSTRACT FROM AUTHOR]