Granisetron 1mg tablets

ObjectiveTo compare the efficacy and safety of pharmaceutical interventions to prevent etomidate-induced myoclonus (EIM), providing the optimal intervention for clinical practice.MethodsPubMed, Embase, the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Chinese National Knowledge Infrastructure, WanFang database, and SinoMed database were searched from the inception to sixth May 2024. We included randomized controlled trials (RCTs) comparing intravenous pharmaceutical interventions to prevent EIM with placebo, no intervention, or another pharmaceutical intervention.ResultsForty-eight RCTs involving 4,768 participants randomly assigned to 20 intravenous pharmaceutical interventions and normal saline were included. Granisetron (odds ratio [OR]: 0.01, 95% confidence interval [CI]: 0.00 to 0.06; one study, moderate certainty) and oxycodone (OR: 0.01, 95% CI: 0.00 to 0.05; three studies, low certainty) was found to be the most effective intervention in reducing the risk of EIM and ranked highest in terms of surface under the cumulative ranking values (94.4% and 89.7% probability), followed by sufentanil (76.5% probability) and remifentanil (74.8% probability). Further subgroup analysis of EIM at mild, moderate-to-severe levels highlighted granisetron and oxycodone as the favorable interventions for reducing EIM. For safety outcomes, the synthesized results indicated that opioids were associated with a higher risk of adverse events (AEs), while no severe AEs were observed.ConclusionModerate-to-low certainty evidence indicated that granisetron and oxycodone may represent the optimal intervention for reducing the risk of overall and moderate-to-severe EIM with a reasonable safety profile, providing the potential interventions for clinical practice.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=291275.

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BackgroundGynecological surgery is generally associated with a high risk of postoperative nausea and vomiting (PONV), for which a combination of antiemetic therapies is advised, but adherence to these protocols is often low. Given the current reality, a preferred 5-HT3 receptor antagonist for preventing PONV as a result of gynecological operations might be desirable. However, the efficiency of different 5-HT3 receptor antagonists in gynecological operations was not clear.ObjectiveTo assess the effectiveness of different 5-HT3 antagonists in preventing PONV after gynecological surgery.Search strategyElectronic databases, including PubMed, Embase, the Cochrane Library, and Web of Science, were searched for randomized clinical trials (RCTs) from their inception up to September 20, 2023.Selection criteriaPatients who received only 5-HT3 antagonists to prevent nausea and vomiting following gynecologic surgical procedures were included. Only RCT articles and English language literature were included.Data collection and analysisTwo investigators independently assessed the study quality and performed data extraction. R software and STATA 17 were used for this network meta-analysis to compare treatments using a frequentist approach.Main resultsPalonosetron demonstrated superior efficacy compared with ondansetron, with a significant difference in "acute nausea," "overall nausea," "acute vomiting," "late vomiting," "late PONV," "overall PONV," "late rescue medicine" and ">24 h rescue medicine." There was a significant difference between palonosetron and ramosetron in "acute nausea," between ramosetron and ondansetron in ">24 h nausea," and between granisetron and ondansetron in "late vomiting." Additionally, granisetron and palonosetron are generally ranked higher in the P-score system.ConclusionsIn gynecological surgery, palonosetron demonstrated superior efficacy to ondansetron. Granisetron seemed to be the most effective alternative to palonosetron in our study.

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