ﺩﮐﺘﺮ ﺷﻌﻠﻪ ﻧﺴﻴﻮﻥ ﭘﻮﺭ- ﻣ ﻘﺎﻳﺴﻪ ﺩﮔﺰﺍﻣﺘﺎﺯﻭﻥ، ﮔﺮﺍﻧﻴﺴﺘﺮﻭﻥ ﻭ ﻣﺘﻮﮐﻠﻮﭘﺮﺍﻣﻴﺪ ﺩﺭ ﭘﻴﺶ ﮔﻴﺮﻱ ﺍﺯ ﭘﺲ ﺍﺯ ﻋﻤﻞ ﮐﺎﺗﺎﺭﺍﮐﺖ ٤١٣ A Comparative Study of Dexamethasone, Granisetron and Metoclopramide for Prevention of Nausea and Vomiting after Cataract Surgery Nesioonpour SH, MD; Pipelzadeh MH, MD; Mohtadi AR, MD; Rezai S, MD; Feghhi M, MD; Malekshoar M, MD Purpose: To compare the efficacy of granisetron, metoclopramide and dexamethasone in prevention of post operative nausea and vomiting (PONV) after cataract surgery. Methods: Sixty patients scheduled for cataract surgery with age between 45 to 80 years and with ASA class I & II were enrolled in this clinical trial. The patients were randomly allocated to three 20- person groups. The induction of anesthesia in all groups was similar using the same drugs. Granisetron 1 mg IV was administered to patients in the first group and metoclopramide 0.2 mg/kg/IV (Max: 10 mg) was administered to the second group at the end of the surgery. In the third group dexamethasone 0.15 mg/kg/IV (Max: 8 mg) was used before surgery. Patients in all three groups were observed for PONV at defined intervals for 24 hours. Results: Incidence of PONV during first 6 hours after surgery was 5% in granisetron group, 35% in metoclopramide group and 15% in dexamethasone group. Only the difference between granisetron and metoclopramide groups was statistically significant (P= 0.01). Incidence of late PONV (6-24 h) was 5% in granisetron group, 30% in metoclopramide group and zero in dexamethasone group. This difference was statistically significant (P<0.01). Conclusion: Granisetron is more effective than metoclopramide in prevention of PONV after cataract surgery. Granisetron and dexamethasone are more effective than metoclopramide in prevention of late PONV after cataract surgery. • Bina J Ophthalmol 2009; 14 (4): 413-419.                         !"#  $%& ’  ()* +,  -#  د   ن ر ١ ،  د     زاد ٢ ،  در ا! ي ١ ،  د#    ر$% ٢ ،  د&’( $ !)* $ ٣ و دداد! - ر . ﻫﺪﻑ: ﻣﻘﺎﻳﺴﻪ ﺍﺛﺮﺑﺨﺸﻲ ﺳﻪ ﺩﺍﺭﻭﻱ ﮔﺮﺍﻧﻴﺴﺘﺮﻭﻥ، ﻣﺘﻮﻛﻠﻮﭘﺮﺍﻣﻴﺪ ﻭ ﺩﮔﺰﺍﻣﺘﺎ ﺯﻭﻥ ﺩﺭ ﭘﻴﺶ ﮔﻴﺮﻱ ﺍﺯ ﻭﻗﻮﻉ ﺗﻬﻮﻉ ﻭ ﺍﺳﺘﻔﺮﺍﻍ ﭘﺲ ﺍﺯ ﻋﻤﻞ ﺟﺮﺍﺣﻲ ﻛﺎﺗﺎﺭﺍﻛﺖ. ﺭﻭﺵ ﭘ ﮋ ﻭﻫﺶ: ۶۰ ﺑﻴﻤﺎﺭ ﻛﺎﻧﺪﻳﺪ ﺟﺮﺍﺣﻲ ﻛﺎﺗﺎﺭﺍﻛﺖ ﺑﺎ ﻣﺤـﺪﻭﺩﻩ ﺳـﻨﻲ۸۰ - ۴۵ ﺳـﺎﻝ ﻭ ﻛـﻼﺱ  ﻭ ﺩﺭ ﻳـﻚ ﻛﺎﺭﺁﺯﻣـﺎﻳﻲ ﺑﺎﻟﻴﻨﻲ ﺍﺯ ﻧﻈﺮ ﺍﺛﺮﺑﺨﺸﻲ ﺩﺍﺭﻭﻫﺎﻱ ﺿﺪ ﺗﻬﻮﻉ ﻣﻮﺭﺩ ﻣﻘﺎﻳﺴﻪ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻨﺪ. ﺑﻴﻤﺎﺭﺍﻥ ﺑﻪ ﺻﻮﺭﺕ ﺗﺼﺎﺩﻓﻲ ﺑﻪ ﺳﻪ ﮔـﺮﻭﻩ۲۰ ﻧﻔـﺮﻩ ﺗﻘـﺴﻴﻢ ﺷﺪﻧﺪ ﻭ ﺍﻟﻘﺎﻱ ﺑﻲ ﻫﻮﺷﻲ ﺩﺭ ﻫﺮ ﺳﻪ ﮔﺮﻭﻩ ﺑﺎ ﻳﻚ ﺭﻭﺵ ﻭ ﺑﺎ ﺩﺍﺭﻭﻫﺎﻱ ﻳﻜﺴﺎﻥ ﺻﻮﺭﺕ ﮔﺮﻓﺖ. ﺑﻪ ﻳـﻚ ﮔـﺮﻭﻩ ﺍﺯ ﺑﻴﻤـﺎﺭﺍﻥ ﮔﺮﺍﻧﻴـﺴﺘﺮﻭﻥ  ۱ ﻭﺭﻳﺪﻱ ﺩﺭ ﭘﺎﻳﺎﻥ ﻋﻤﻞ ﺟﺮﺍﺣﻲ، ﺑﻪ ﮔﺮﻭﻩ ﺩﻳﮕﺮ ﻣﺘﻮﻛﻠﻮﭘﺮﺍﻣﻴﺪ ۲ / ۰ ﻭﺭﻳﺪﻱ) ﺣﺪﺍﻛﺜﺮ ۱۰ ( ﺩﺭ ﭘﺎﻳﺎﻥ ﻋﻤﻞ ﺟﺮﺍﺣـﻲ ﻭ ﺑﻪ ﮔﺮﻭﻩ ﺳﻮﻡ ﺩﮔﺰﺍﻣﺘ ﺎﺯﻭﻥ ۱۵ / ۰ ﻭﺭﻳﺪﻱ) ﺣﺪﺍﻛﺜﺮ ۸ ( ﭘﻴﺶ ﺍﺯ ﺷﺮﻭﻉ ﺟﺮﺍﺣﻲ ﺗﺠﻮﻳﺰ ﮔﺮﺩﻳـﺪ. ﺳـﻪ ﮔـﺮﻭﻩ ﻓـﻮﻕ ﻃـﻲ۲۴ ﺳﺎﻋﺖ ﭘﺲ ﺍﺯ ﻋﻤﻞ ﺩﺭ ﻓﻮﺍﺻﻞ ﺯﻣﺎﻧﻲ ﻣﺸﺨﺺ ﺍﺯ ﻧﻈﺮ ﺑﺮﻭﺯ ﺗﻬﻮﻉ ﻭ ﺍﺳﺘﻔﺮﺍﻍ ﺑﺮﺭﺳﻲ ﺷﺪﻧﺪ. ﻳﺎﻓﺘﻪ ﻫﺎ: ﻓﺮﺍﻭﺍﻧﻲ ﺗﻬﻮﻉ ﻭ ﺍﺳﺘﻔﺮﺍﻍ ﺩﺭ ﻃﻮﻝ۶ ﺳﺎﻋﺖ ﺍﻭﻝ ﭘﺲ ﺍﺯ ﻋﻤﻞ ﺩﺭ ﮔﺮﻭﻩ ﮔﺮﺍﻧﻴﺴﺘﺮﻭﻥ۵ ﺩﺭﺻﺪ ، ﺩﺭ ﮔـﺮﻭﻩ ﻣ ﺘﻮﻛﻠﻮﭘﺮﺍﻣﻴـﺪ۳۵ ﺩﺭﺻﺪ ﻭ ﺩﺭ ﮔﺮﻭﻩ ﺩﮔﺰﺍﻣﺘﺎﺯﻭﻥ۱۵ ﺩﺭﺻﺪ ﺑﻮﺩ. ﺩﺭ ﺍﻳﻦ ﻣﻴﺎﻥ ﺗﻨﻬﺎ ﺑﻴﻦ ﮔﺮﻭﻩ ﮔﺮﺍﻧﻴـﺴﺘﺮﻭﻥ ﻭ ﻣﺘﻮﻛﻠﻮﭘﺮﺍﻣﻴـﺪ ﺍﺯ ﻧﻈـﺮ ﺁﻣـﺎﺭﻱ ﺍﺧـﺘﻼﻑ ﻣﻌﻨﻲ ﺩﺍﺭﻱ ﻭﺟﻮﺩ ﺩﺍﺷﺖ) ۰۱ / ۰  ( . ﻓﺮﺍﻭﺍﻧﻲ ﺗﻬﻮﻉ ﻭ ﺍﺳﺘﻔﺮﺍﻍ ﺑﺎ ﺷﺮﻭﻉ ﺩﻳﺮﺭﺱ) ۶ ﺗﺎ۲۴ ﺳﺎﻋﺖ( ﺩﺭ ﮔﺮﻭﻩ ﮔﺮﺍﻧﻴﺴﺘﺮﻭﻥ۵ ﺩﺭﺻﺪ ، ﺩﺭ