RETRACTED ARTICLE: Reduction of postoperative nausea and vomiting with granisetron

The antiemetic effects of granisetron, a selective 5-hydroxy-tryptamine type 3 receptor antagonist, on postoperative nausea and vomiting were studied and compared with placebo and metoclopramide in 60 patients undergoing general anaesthesia for major gynaecological surgery. The patients received a single iv dose of either granisetron (3 mg, n = 20) metoclopramide (10 mg, n = 20), or placebo (saline, n = 20) immediately after recovery from anaesthesia. The effects were assessed during the first three and the next 21 hr after recovery from anaesthesia by means of a nausea and vomiting score; 0 = no emetic symptoms, 1 = nausea, 2 = vomiting. The mean scores during 0–3 hr were 0.8, 0.1 and 0.1 after administration of placebo, metoclopramide and granisetron, respectively; the corresponding scores during 3–24 hr were 0.6, 0.5 and 0.1. The scores of the metoclopramide and the granisetron groups were different from the placebo group in the first three hours (P < 0.05). Although there were no differences in the scores during 0–3 hr between the metoclopramide and the granisetron groups, there were differences during 3–24 hr (P < 0.05). It is concluded that granisetron is superior to metoclopramide in the long-term prevention of postoperative nausea and vomiting after anaesthesia.     

RETRACTED ARTICLE: Ramosetronvs granisetron for the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy

PURPOSE: To compare the efficacy of ramosetron with granisetron for the prevention of postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy. METHODS: In a randomized, double-blind study, 80 female inpatients received 3 mg granisetron or 0.3 mg ramosetron i.v. (n=40 of each) at the completion of surgery The standardized anesthetic included isoflurane and nitrous oxide in oxygen. RESULTS: Complete response, defined as no PONV, during the first 24 hr (0-24 hr) after anesthesia was 85% with granisetron and 93% with ramosetron, respectively (P=0.241); the corresponding incidence during the next 24 hr (24-48 hr) after anesthesia was 63% and 90% (P=0.004). No clinically important adverse events due to the study drug were observed in any of the groups. CONCLUSION: Ramosetron was more effective than granisetron for prevention of PONV during 0-48 hr after anesthesia for laparoscopic cholecystectomy.     

RETRACTED ARTICLE: Prevention of postoperative nausea and vomiting with granisetron: a randomized,double-blind comparison with droperidol

The effects of granisetron for preventing postoperative nausea and vomiting were investigated in a randomized, double-blind comparison with droperidol and placebo in 100 patients undergoing general anaesthesia for major gynaecological surgery. The patients received a single dose of either granisetron (40 μg · kg^{? 1}, n = 25), dropéridol (1.25 mg, n = 25; 2.5 mg n = 25) or placebo (saline, n = 25) iv over two to five minutes immediately before induction of anaesthesia. The antiemetic effects of these drugs were evaluated during the first three and the next 21 hr after recovery from anaesthesia. During 0– 3 hr after anaesthesia, the frequency of nausea and vomiting was 60%, 12%, 16% and 12% after administration of placebo, granisetron, droperidol 1.25 mg or droperidol 2.5 mg, respectively. The corresponding frequencies during 3– 24 hr after anaesthesia were 44%, 8%, 36% and 12%. The efficacy of granisetron in preventing postoperative nausea and vomiting was almost equal to that of droperidol 2.5 mg. The awakening time in the patients who had received droperidol 2.5 mg was prolonged by approximately three minutes compared with the placebo group (P < 0.05), and postoperative drowsiness/sedation was observed in these patients. In conclusion, preoperative prophylactic administration of granisetron is superior to that of droperidol in the prevention of postoperative nausea and vomiting after anaesthesia.     

RETRACTED ARTICLE: Granisetron-dexamethasone combination reduces postoperative nausea and vomiting

Canadian Journal of Anesthesia/Journal canadien d'anesthésie - The prophylactic antiemetic efficacy of combined granisetron and dexamethasone was evaluated in a randomized doubleblind...     

Prevention of postoperative vomiting with granisetron in paediatric patients with and without a history of motion sickness

A history of motion sickness is one of the patient-related factors associated with postoperative emesis. This prospective, randomized, double-blind, placebo-controlled study was undertaken to assess the efficacy of granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, for preventing postoperative vomiting after tonsillectomy in 120 children with (n = 60) and without (n = 60) a history of motion sickness. Patients received a single dose of granisetron (40 micrograms.kg-1) or placebo (saline) (n = 30 of each) intravenously after an inhalation induction of anaesthesia. A complete response, defined as no vomiting, no retching and no need for another rescue medication, during the first 24 h after anaesthesia was 77% and 13% in patients with a history of motion sickness who had received granisetron or placebo, respectively; the corresponding incidence was 83% and 40% in those without it (P < 0.05; chi 2 test with Yates' continuity correction). No clinically serious adverse effects due to the study drug were observed in any of the groups. In conclusion, prophylactic antiemetic therapy with granisetron is effective for preventing postoperative emesis in children with a history of motion sickness as well as in those without it.     

RETRACTED ARTICLE: Optimal anti-emetic dose of granisetron for preventing post-operative nausea and vomiting

In order to determine the optimal effective dose of granisetron for preventing postoperative nausea and vomiting, the drug was administered in doses of either 20, 40 or 60 μg sd kg^?1. The efficacy of granisetron was evaluated in a randomized, double-blind comparison with placebo in 100 patients undergoing general anaesthesia for major gynaecological surgery. The patients received a single dose of either granisetron or placebo (saline) iv immediately after recovery from anaesthesia. The effects were assessed during the 24 hr after recovery from anaesthesia by means of a nausea and vomiting score; 0 = no emetic symptoms, 1 = nausea, 2 = vomiting. The treatment groups were similar for patient characteristics, surgical procedures and anaesthetics administered. The mean scores were 0.7, 0.6, 0.2 and 0.2 after administration of placebo, granisetron 20, 40 and 60 μg · kg^?1, respectively. Granisetron 40 μg · kg^?1 was as effective as 60 μg · kg^?1 and both resulted in reduction of the scores compared with placebo and granisetron 20 μg · kg^?1 (P < 0.05). In conclusion, granisetron 40 μg · kg^?1 is considered to be the appropriate dosage for preventing postoperative emesis after anaesthesia.     

RETRACTED ARTICLE: Prophylactic antiemetic efficacy of granisetron in patients with and without previous postoperative emesis

Purpose

To evaluate the efficacy of granisetron, a selective antagonist of 5-hydroxytryptamine type 3 receptors. in the prevention of PONV in patients with and without previous postoperative emesis undergoing general anaesthesia for major gynaecological surgery.

Methods

In a randomized, double-blind, placebo-controlled trial of 90 women with (n=40) and without (n = 50) a history of PONV the patients received either granisetron (40 μg·kg^?1) or placebo (saline)iv immediately before induction of anaesthesia. The same standard general anaesthetic technique, which consisted of isoflurane in nitrous oxide and oxygen and avoided opioids, was used. Nausea, vomiting and safety assessments were performed during the first 24 hr after anaesthesia.

Results

The incidence of PONV was 70% and 25% after administration of placebo and granisetron in patients with previous PONV (P < 0.05), and was 40% and 8% in patients without it, respectively (P < 0.05). The incidence of adverse events postoperatively were not different among the treatment groups.

Conclusion

Granisetron 40 μg·kg given prior to anaesthesia reduces the incidence of PONV in patients with a history of PONV as well as in patients without it.     

RETRACTED ARTICLE: Granisetron reduces postoperative nausea and vomiting throughout menstrual cycle

Purpose

The incidence of postoperative nausea and vomiting (PONV) is influenced by menstruation. This study was undertaken to assess the efficacy of granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, for preventing PONV in patients during two different phases of menstrual cycle.

Methods

One hundred twenty female patients undergoing general anaesthesia for major gynaecological surgery were divided according to the phase of menstrual cycle into two groups: day one to eight (menstrual) and day nine to end of the cycle (non-menstrual) groups. In a randomized, double-blind manner, the patients received placebo (saline) or 40μg·kg^?1 granisetroniv immediately before the induction of anaesthesia. All patients received a standardized general and epidural anaesthesia and epidural morphine plus bupivacaine for postoperative analgesia. The incidence of PONV and other adverse events was recorded during the first 24 hr after anaesthesia.

Results

The treatment groups were similar with respect to patient demographics, types of surgery, anaesthetics administered and analgesics used postoperatively. The incidence of PONV was 72% and 32% in patients during menstruation receiving placebo or granisetron (P < 0.05), and was 46% and 20% in those during non-menstruation, respectively (P < 0.05). No differences in the incidence of other adverse events were observed among the groups.

Conclusion

Granisetron was effective in reducing the incidence of PONV in both phases of the menstrual cycle studied.

Objectif

Les menstruations influencent l’incidence des nausées et des vomissements postopératoires (NVPO). Cette étude visait à évaluer I’efficacité du granisetron, un antagoniste du récepteur de la 5-hydroxytryptamine de type 3, administré pour la prévention des NVPO pendant les différentes phases du cycle menstruel.

Méthodes

Cent vingt patientes programmées pour une chirurgie gynécologique majeure sous anesthésie générate ont été réparties en deux groupes déterminés par la phase de leur cycle menstruel: du premier au huitième jour («menstruel») et du neuvième jour à la fin du cycle («non menstruel»). En double aveugle et aléatoirement, les patientes ont reçu un placebo (du sol. phys.) ou 40μg·kg^?1 de granisetroniv immédiatement avant I’induction de I’anesthésie. Toutes les patientes ont reçu une anesthésie générale ou épidurale standard et de la morphine épidurale avec ajout de bupivacaïne pour I’analgésie postopératoire. L’incidence des NVPO et des autres incidents a été enregistrée pendant 24 h après I’anesthésie.

Résultats

Les deux groupes étaient identiques sur le plan de la démographie, du type de chirurgie, de I’anesthésie et des analgésiques administrés en postopératoire. L’incidence des NVPO a été respectivement de 72% et de 32% dans le groupe menstruel recevant le placebo et le granisetron (P < 0,05) et de 46% et de 20% dans le groupe non menstruel (P < 0,05). L’incidence des complications a été la même dans les deux groupes.

Conclusion

Le granisetron a réduit efficacement complications des NVPO pendant les deux phases du cycle menstruel.     

RETRACTED ARTICLE: Prevention of PONV with granisetron, droperidol and metoclopramide in female patients with history of motion sickness

Purpose

Motion sickness is one of the patient-related factors associated with postoperative nausea and vomiting (PONV). This study was undertaken to assess the efficacy of granisetron, droperidol and metoclopramide for preventing PONV in female patients with a history of motion sickness undergoing major gynaecological surgery.

Methods

In a prospective, randomized, placebo-controlled, double-blind study. 120 patients received either 1.25 mg dropendol. 10 mg metoclopramide, 40 μkg granisetron or placebo (saline)iv immediately before induction of anaesthesia. A standardized anaesthetic technique and postoperative analgesia were used in all patients. During the first 24 hr after anaesthesia, the incidence of PONV and adverse events were recorded by nursing-staff.

Results

The treatment groups were similar for patient demographics, types of surgery, anaesthetics administered and opioid given. The incidence of PONV was 70%, 50%. 57% and 23% in the placebo, droperidol, metoclopramide and granisetron groups, respectively (P < 0.05; overall χ² test). No difference in the incidence of adverse events was observed in either group.

Conclusion

Granisetron is a better prophylactic antiemetic than dropendol or metoclopramide in female patients with a history of motion sickness undergoing major gynaecological surgery.     

Dexamethasone prevents postoperative nausea and vomiting more effectively in women with motion sickness

PURPOSE: To evaluate the antiemetic effect of iv dexamethasone for preventing postoperative nausea and vomiting (PONV) in women with and without a history of motion sickness. METHODS: This randomized, double-blinded, placebo-controlled study was carried out in 168 female patients with (n = 84) and without (n = 84) a history of motion sickness undergoing gynecological laparoscopy. Patients received 8 mg dexamethasone or saline immediately before induction of anesthesia. Postoperatively patients were assessed for 24 hr for nausea, vomiting, and complete response (no vomiting, no need for rescue antiemetics). RESULTS: The complete response for patients with a history of motion sickness was 80.5% and 37.5% for recipients of dexamethasone and saline, respectively [P < 0.001; number needed-to-treat (NNT) = 2.3]; with corresponding incidences of 83.3% and 53.7% when there was no such history (P = 0.009; NNT = 3.4). Calculation of the efficacy of dexamethasone for the different subgroups shows that dexamethasone was 45.3% more effective in patients with motion sickness than in those without it. CONCLUSIONS: Prophylactic administration of dexamethasone is effective in reducing PONV in patients with and without a history of motion sickness. The results of this study were more favourable in patients with a history of motion sickness, demonstrating a higher effectiveness of dexamethasone for preventing PONV in this subgroup of patients.     

RETRACTED ARTICLE: Reduction of postoperative nausea, vomiting, and analgesic requirement with dexamethasone for patients undergoing laparoscopic cholecystectomy

Background

Dexamethasone has antiemetic and analgesic effects for various types of surgery. The efficacy of dexamethasone for reducing postoperative nausea and vomiting (PONV) and analgesic requirement has never been evaluated for patients undergoing laparoscopic cholecystectomy (LC).

Methods

In a prospective, randomized, double-blind, placebo-controlled study, patients intravenously received placebo, dexamethasone 4 mg, or dexamethasone 8 mg immediately before induction of anesthesia. A standard anesthetic technique, including sevoflurane and air in oxygen, was used. Postoperatively, emetic symptoms (nausea, retching, and vomiting) and analgesic requirement were evaluated by an investigator.

Results

The study enrolled 90 patients (38 men and 52 nonpregnant women), with each treatment group comprising 30 patients. The rate of patients experiencing PONV 0–24 h after anesthesia was 60% for the dexamethasone 4 mg group (p = 0.294) and 33% for the dexamethasone 8 mg group (p = 0.01), compared with 70% for the placebo group. The need for indomethacin to relieve intolerable pain was less in the dexamethasone 8 mg group than in the placebo group (p = 0.008) or the dexamethasone 4 mg group (p = 0.029). No difference in analgesic requirement was found between the dexamethasone 4 mg group and the placebo group (p = 0.395). No clinically important adverse effects due to the study drug were observed in any group.

Conclusions

Prophylactic therapy with dexamethasone 8 mg is effective in reducing PONV and analgesic requirement for patients undergoing LC.     

Preoperative oral granisetron prevents postoperative nausea and vomiting

Background: Postoperative nausea and vomiting (PONV) is a commonly observed adverse effect of anaesthesia. This study was designed to evaluate the efficacy of granisetron administered orally for preventing PONV in female patients undergoing major gynaecological surgery.
Methods: In a prospective, randomized, placebo-controlled, double-blind study, 120 patients received orally either placebo or granisetron (1 mg, 2 mg or 4 mg) (n=30 for each) 1 h before surgery. The same standard general plus regional anaesthetic technique was employed throughout. Postoperatively, during the first 24 h after anaesthesia, the incidence of PONV and adverse events was recorded by nursing staff.
Results: The incidence of PONV was 47% with placebo, 37% with granisetron 1 mg, 10% with granisetron 2 mg and 10% with granisetron 4 mg (P<0.05; overall Fisher's exact probability test). No difference in the incidence of adverse events was observed among the groups.
Conclusion: Preoperative oral granisetron in a minimum dose of 2 mg is effective for preventing PONV after major gynaecological surgery.     

RETRACTED ARTICLE: Antiemetic efficacy of granisetron and metoclopramide in children undergoing ophthalmic or ENT surgery

Purpose

The purpose of this study was to compare the effectiveness of granisetron, metoclopramide and placebo in reducing the frequencies of retching and vomiting in children who had undergone strabismus repair and tonsillectomy with or without adenoidectomy.

Methods

In a randomized, double-blind study, 70 healthy subjects, 4–10 yr of age, were given a single dose of either placebo (saline, n = 24), metoclopramide 0.25 mg · kg^?1 (n = 23) granisetron 40 μg · kg^?1 (n = 23) iv over two to five minutes after the induction of anaesthesia. All subjects received inhalation anaesthesia with sevoflurane and nitrous oxide in oxygen. Rescue antiemetics were administered if two or more episodes of vomiting occurred. Acetaminophen pr or pentazocine iv was given as needed for postoperative pain. All subjects remained in hospital for two days. During the first three and the next 21 hr after anaesthesia, the frequencies of retching and vomiting were recorded by nursing staff.

Results

There was no difference among groups with regard to demographic characteristics, surgical procedures, anaesthetics administered, postoperative managements, or adverse effects. During 0–3 hr after anaesthesia, the frequencies of retching and vomiting were: placebo 62%, metoclopramide 22% and granisetron 13% (P < 0.05). The corresponding frequencies during 3–24 hr after anaesthesia were: placebo 50%, metoclopramide 39% and granisetron 13% (P < 0.05). Four children who had received placebo and three who had received metoclopramide required another rescue antiemetic.

Conclusion

Granisetron 40 μg · kg^?1 is more effective than either metoclopramide or placebo in reducing the frequencies of postoperative retching and vomiting during the first 24 hr after anaesthesia in children who have undergone strabismus surgery and tonsillectomy with or without adenoidectomy.     

RETRACTED ARTICLE: Prevention of PONV with granisetron, droperidol or metoclopramide in patients with postoperative emesis

Purpose

A high incidence of postoperative nausea and vomiting (PONV) has been noted in patients with a history of postoperative emesis. This study was undertaken to compare the efficacy of granisetron, droperidol and metoclopramide, in the prevention of PONV in such patients undergoing general anaesthesia for major gynaecological surgery.

Methods

In a randomised, double-blind study, 90 female patients received 2.5 mg granisetron, 1.25 mg droperidol or 10 mg metoclopramide (n = 30 of each)iv immediately before induction of anaesthesia. The same standard general anaesthetic technique, which consisted of isoflurane in nitrous oxide and oxygen, was used. Nausea, vomiting and safety assessments were performed continuously during the first 24 hr after anaesthesia.

Results

The incidence of PONV was 20% with granisetron, 57% with droperidol and 60% with metoclopramide (P < 0.05; overall Fisher’s exact probability test). No clinically adverse events were observed in any group.

Conclusion

Granisetron is more effective than droperidol or metoclopramide in preventing PONV in female patients with a history of postoperative emesis.     

RETRACTED ARTICLE: Effective dose of granisetron for preventing postoperative emesis in children

Purpose

This study was to identify the minimum effective dose of granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, to prevent postoperative vomiting in children who have undergone strabismus repair, tonsillectomy or tonsillectomy with adenoidectomy.

Methods

In a randomized, double-blind fashion, 80 healthy children aged 4–10 yr were assigned to receive either placebo (saline) or granisetron in a dose of 20, 40 or 80 μg· kg^?1 iv immediately following the induction of anaesthesia. All subjects received a standardized anaesthetic, which consisted of sevoflurane in nitrous oxide and oxygen. Rescue antiemetics were administered if two or more episodes of vomiting occurred. Postoperative pain was treated with acetaminophene pr or pentazocine iv. During the first 24 hr after anaesthesia, the frequencies of retching and vomiting were recorded in a standardized fashion by nursing staff while subjects were in a hospital.

Results

There were no differences among four treatment groups with regard to subject characteristics, surgical procedures, anaesthetic and postoperative management or adverse effects. The frequencies of these symptoms were as follows: 65%, 60%, 20% and 15% after administration of placebo, granisetron 20, 40 or 80 μg· kg^?1. Three children who had received either placebo or granisetron 20 μg · kg^?1 required another rescue antiemetic drug, whereas none who had received granisetron 40 or 80 μg · kg^?1 needed rescue drugs.

Conclusion

Granisetron 40 μg · kg^?1 is an effective antiemetic for preventing retching and vomiting following strabismus repair and tonsillectomy in children. Increasing the dose to 80 μg ·kg ^?1 provided no demonstrable benefit in reducing postoperative emesis.