{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:05:41Z","timestamp":1787169941431,"version":"build-2736575974"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,2]]},"abstract":"\n Background and Aims:<\/jats:title>\n Patients undergoing neurosurgical procedures are at a high risk of post-operative nausea and vomiting (PONV). Amisulpride, a dopamine (D2, D3) receptor antagonist, has been recently approved for intravenous use in antiemesis and has demonstrated safety and efficacy in managing PONV in non-neurosurgical settings. We hypothesised that amisulpride would be non-inferior to ondansetron in preventing PONV.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Adult patients scheduled for elective supratentorial craniotomy for tumour surgery under general anaesthesia were randomised to receive either intravenous amisulpride (5 mg) or intravenous ondansetron (4 mg) intra-operatively, administered 30 minutes before skin closure. Patients were then assessed for PONV in the post-operative intensive care unit. The primary objective was to evaluate the incidence of nausea and vomiting in the first 24 hours post-operatively. Secondary outcomes included nausea severity, the need for rescue antiemetic medications, and treatment-related adverse events. Incidence of PONV was compared using the Chi-square test. Secondary outcomes like severity of nausea, rescue medications, and adverse events were tested using Chi-square\/Fisher\u2019s exact test. Non-inferiority of amisulpride to ondansetron was assessed using the pre-specified absolute non-inferiority margin of 20%.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n A total of 100 patients were included in the final analysis. The incidence of nausea and vomiting was significantly lower in the amisulpride group (22% and 8%) compared to the ondansetron group (36% and 8%) (\n P<\/jats:italic>\n = 0.032 and\n P<\/jats:italic>\n = 0.045, respectively). Nausea severity was also significantly lower in the amisulpride group during the first four post-operative hours (\n P<\/jats:italic>\n < 0.05). Additionally, patients receiving amisulpride required fewer rescue antiemetics. No treatment-related adverse events were observed in the amisulpride group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n A single intra-operative intravenous dose of amisulpride (5 mg) at the end of the surgery was found to be non-inferior to 4 mg intravenous ondansetron in reducing the incidence and severity of PONV in patients undergoing supratentorial craniotomy.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ija.ija_350_25","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T17:00:14Z","timestamp":1771606814000},"page":"358-365","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of intravenous amisulpride and ondansetron in preventing post-operative nausea and vomiting in patients undergoing craniotomy for supratentorial tumour surgery: A randomised non-inferiority trial"],"prefix":"10.4103","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8220-1493","authenticated-orcid":false,"given":"Sreeja","family":"Ravindranath","sequence":"first","affiliation":[{"name":"Division of Neuroanaesthesia and Neurocritical Care, Department of Anaesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9419-0543","authenticated-orcid":false,"given":"Ajay Prasad","family":"Hrishi","sequence":"additional","affiliation":[{"name":"Division of Neuroanaesthesia and Neurocritical Care, Department of Anaesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6103-551X","authenticated-orcid":false,"given":"Manikandan","family":"Sethuraman","sequence":"additional","affiliation":[{"name":"Division of Neuroanaesthesia and Neurocritical Care, Department of Anaesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0183-8596","authenticated-orcid":false,"given":"C S Ranganatha","family":"Praveen","sequence":"additional","affiliation":[{"name":"Division of Neuroanaesthesia and Neurocritical Care, Department of Anaesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4834-4497","authenticated-orcid":false,"given":"Krishnakumar","family":"Kesavapisharady","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,2,21]]},"reference":[{"key":"R1-20260417","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1097\/ANA.0000000000000667","article-title":"Postoperative nausea and vomiting after craniotomy: An evidence-based review of general considerations, risk factors, and management","volume":"33","author":"Uribe","year":"2021","journal-title":"J Neurosurg Anesthesiol"},{"key":"R2-20260417","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1186\/s12883-020-01837-7","article-title":"Changing the paradigm of intracranial 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