Granisetron Effect on Hemodynamic Changes in Laparoscopic Cholecystectomy
Condition: Cholelithiasis
MeSH terms: Cholelithiasis; Cholecystolithiasis; Gallstones
Study type: Interventional
Phase: Phase 4

Summary: 
      Propofol is one of the most commonly used anesthetic agents because of its ability to induce
      rapid and reliable collection. However, hypotension and injection pain in the induction are
      the most common complications. After induction of propofol; The cardiovascular system
      depresses, resulting in a drop in blood pressure due to decreased cardiac output and systemic
      vascular resistance. This may also contribute to the reduction of sympathetic tone activity
      in the central way, and slight reduction in the number of pulses that develop as a result of
      increasing vagal activity. İn order to attenuate these hemodynamic undesired effects caused
      by propofol, various agents were tried such as atropine, ephedrine, volume replacement ringer
      lactate, ketamine. Ondansetron and granisetron, which are used for postoperative nausea and
      vomiting prophylaxis, have been used as such. Therefore, ondansetron and granisetron were
      preventing hypotension induced by post-spinal and general anesthesia induction.

      The investigator also tried to demonstrate the effect of granisetron, another serotonin type
      3 (5-HT3) receptor antagonist for postoperative nausea and vomiting prophylaxis, on induction
      hypotension and intubation quality after propofol induction in this study
    

Detailed description: 
      150 participants with American Society of Anesthesiologists (ASA) physical score I-II who
      underwent elective laparoscopic cholecystectomy between the ages of 18-70 will be enrolled.
      Participants will be divided into two groups using granisetron and control.

      All participants will be premedicated with 0.05 mg kg-1 midazolam 30 minutes before the
      operation. ASA, age, sex, weight demographic data of the participants who were taken to the
      operating room will record. Peripheral oxygen saturation (SPO2), noninvasive blood pressure
      and electrocardiography (ECG) will monitored. A venous cannula will place on the back of the
      hand. Participants will randomly divide into 2 groups by closed envelope method.

      Five minutes before the induction of group G, 1 ml (1 mg / ml) iv granisetron, group K will
      receive 1 ml saline. Propofol at induction will be administered at a dose of 0.6 mg / kg of
      rocuronium at a dose of 2 mg / kg. Pre-induction, post-intubation and every five minutes
      SPO2, diastolic arterial pressure (DAP), mean arterial pressure (MAP), systolic arterial
      pressure(SAP) and heart rate (HR) will record. Intubation quality will be evaluated by evans
      score.

      Systolic Blood Pressure <Control + 15 0 <Control + 30 1 1

        -  Control + 30 2 Heart Rate Pressure <Control + 15 0 <Control + 30 1

        -  Control + 30 2 Sweating No 0 Moist leather 1 Visible sweating 2 Tears No 0 Yes 1
           Overflowing 2
    

Intervention name(s): Granisetron 1 Mg/mL Intravenous Solution
Intervention type(s): Drug
Intervention description(s): 1 milligram (mg) will use on group Granisetron before 5 min induction
Intervention MeSH terms: Granisetron
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Prevention