Prevention of postoperative nausea and vomiting in patients undergoing laparoscopic bariatric surgery--granisetron alone vs granisetron combined with dexamethasone/droperidol

BACKGROUND AND OBJECTIVES: Laparoscopic bariatric surgeries are associated with an appreciably high rate of postoperative nausea and vomiting. This study was designed to compare the effectiveness of granisetron either alone or in combination with droperidol or dexamethasone, for the prevention of post operative nausea and vomiting (PONV) in patients undergoing laparoscopic bariatric surgeries. METHODS: In a randomized, double-blind, placebo-controlled trial, 120 patients received either Granisetron 1 mg, Granisetron 1 mg plus Droperidol 1.25 mg, Granisetron 1 mg plus Dexamethasone 8 mg or Placebo (saline), intravenously immediately before induction of anesthesia. Perioperative anesthetic care was standardized in all patients. Patients were then observed for 24 hours after administration of the study drugs. RESULTS: The incidence of PONV was 30% with granisetron alone, 30% with granisetron plus droperidol, 20%, with granisetron plus dexamethanone, and 67% with placebo. (P < 0.05; overall Fisher's exact probability test). The incidence of adverse events was not different among the 4 groups. CONCLUSION: Graniserton is effective and safe drug for reducing the incidence of PONV in patients undergoing bariatric surgeries, and becomes highly effective when combined with dexamethasone.