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

Authors

• Waleed D. Khubzan, From the Faculty of Medicine (Khubzan); from the Department of Surgery (Mahfouz), Faculty of Medicine, Taif University, Taif, from the Faculty of Medicine (Albagieh, Alsaeed), Imam Mohammed Ibn Saud Islamic University, from the Intensive Care Unit (Nathif), Ministry of National Guard Health Affairs, Riyadh, from the Faculty of Medicine (Alshamrani), University of Jeddah, Jeddah, from the Faculty of Medicine (Alharbi), Unaizah University, Unaizah, and from the Faculty of Medicine (Sharahili), Jazan University, Jazan, Kingdom of Saudi Arabia.
• Mohammed H. Albagieh, From the Faculty of Medicine (Khubzan); from the Department of Surgery (Mahfouz), Faculty of Medicine, Taif University, Taif, from the Faculty of Medicine (Albagieh, Alsaeed), Imam Mohammed Ibn Saud Islamic University, from the Intensive Care Unit (Nathif), Ministry of National Guard Health Affairs, Riyadh, from the Faculty of Medicine (Alshamrani), University of Jeddah, Jeddah, from the Faculty of Medicine (Alharbi), Unaizah University, Unaizah, and from the Faculty of Medicine (Sharahili), Jazan University, Jazan, Kingdom of Saudi Arabia.
• Ruyuf A. Nathif, From the Faculty of Medicine (Khubzan); from the Department of Surgery (Mahfouz), Faculty of Medicine, Taif University, Taif, from the Faculty of Medicine (Albagieh, Alsaeed), Imam Mohammed Ibn Saud Islamic University, from the Intensive Care Unit (Nathif), Ministry of National Guard Health Affairs, Riyadh, from the Faculty of Medicine (Alshamrani), University of Jeddah, Jeddah, from the Faculty of Medicine (Alharbi), Unaizah University, Unaizah, and from the Faculty of Medicine (Sharahili), Jazan University, Jazan, Kingdom of Saudi Arabia.
• Waad M. Alshamrani, From the Faculty of Medicine (Khubzan); from the Department of Surgery (Mahfouz), Faculty of Medicine, Taif University, Taif, from the Faculty of Medicine (Albagieh, Alsaeed), Imam Mohammed Ibn Saud Islamic University, from the Intensive Care Unit (Nathif), Ministry of National Guard Health Affairs, Riyadh, from the Faculty of Medicine (Alshamrani), University of Jeddah, Jeddah, from the Faculty of Medicine (Alharbi), Unaizah University, Unaizah, and from the Faculty of Medicine (Sharahili), Jazan University, Jazan, Kingdom of Saudi Arabia.
• Nawaf S. Alharbi, From the Faculty of Medicine (Khubzan); from the Department of Surgery (Mahfouz), Faculty of Medicine, Taif University, Taif, from the Faculty of Medicine (Albagieh, Alsaeed), Imam Mohammed Ibn Saud Islamic University, from the Intensive Care Unit (Nathif), Ministry of National Guard Health Affairs, Riyadh, from the Faculty of Medicine (Alshamrani), University of Jeddah, Jeddah, from the Faculty of Medicine (Alharbi), Unaizah University, Unaizah, and from the Faculty of Medicine (Sharahili), Jazan University, Jazan, Kingdom of Saudi Arabia.
• Reem A. Sharahili, From the Faculty of Medicine (Khubzan); from the Department of Surgery (Mahfouz), Faculty of Medicine, Taif University, Taif, from the Faculty of Medicine (Albagieh, Alsaeed), Imam Mohammed Ibn Saud Islamic University, from the Intensive Care Unit (Nathif), Ministry of National Guard Health Affairs, Riyadh, from the Faculty of Medicine (Alshamrani), University of Jeddah, Jeddah, from the Faculty of Medicine (Alharbi), Unaizah University, Unaizah, and from the Faculty of Medicine (Sharahili), Jazan University, Jazan, Kingdom of Saudi Arabia.
• Naif M. Alsaeed, From the Faculty of Medicine (Khubzan); from the Department of Surgery (Mahfouz), Faculty of Medicine, Taif University, Taif, from the Faculty of Medicine (Albagieh, Alsaeed), Imam Mohammed Ibn Saud Islamic University, from the Intensive Care Unit (Nathif), Ministry of National Guard Health Affairs, Riyadh, from the Faculty of Medicine (Alshamrani), University of Jeddah, Jeddah, from the Faculty of Medicine (Alharbi), Unaizah University, Unaizah, and from the Faculty of Medicine (Sharahili), Jazan University, Jazan, Kingdom of Saudi Arabia.
• Mohammedeid M. Mahfouz, From the Faculty of Medicine (Khubzan); from the Department of Surgery (Mahfouz), Faculty of Medicine, Taif University, Taif, from the Faculty of Medicine (Albagieh, Alsaeed), Imam Mohammed Ibn Saud Islamic University, from the Intensive Care Unit (Nathif), Ministry of National Guard Health Affairs, Riyadh, from the Faculty of Medicine (Alshamrani), University of Jeddah, Jeddah, from the Faculty of Medicine (Alharbi), Unaizah University, Unaizah, and from the Faculty of Medicine (Sharahili), Jazan University, Jazan, Kingdom of Saudi Arabia.

Abstract

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, I 2 =7%, p =0.0001) and vomiting (10.3% vs. 18%; RR=1.73, I 2 =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%, I 2 =35%) and vomiting (13.4% vs. 23.3%, I 2 =52%), with low-to-moderate heterogeneity. Patients on granisetron required less rescue anti-emetics (10.7% vs. 23.1%; RR=2.14, I 2 =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

Article Type

Systematic Review

First Page

721

Last Page

734

Recommended Citation

Khubzan, Waleed D.; Albagieh, Mohammed H.; Nathif, Ruyuf A.; Alshamrani, Waad M.; Alharbi, Nawaf S.; Sharahili, Reem A.; Alsaeed, Naif M.; and Mahfouz, Mohammedeid M. (2025) "Comparison between ondansetron and granisetron in preventing nausea and vomiting after laparoscopic cholecystectomy: A systematic review and meta-analysis," Saudi Medical Journal: Vol. 46: Iss. 7, Article 2.
DOI: https://doi.org/10.15537/smj.2025.46.7.20250185