Canadian Journal of Anaesthesia

, Volume 42, Issue 10, pp 852–856 | Cite as

RETRACTED ARTICLE: Prevention of postoperative nausea and vomiting with granisetron: a randomized, double-blind comparison with droperidol

  • Yoshitaka Fujii
  • Hiroyoshi Tanaka
  • Hidenori Toyooka
Reports and Investigation

Abstract

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.

Key words

complications: nausea, vomiting vomiting: antiemetics, granisetron, droperidol, incidence, nausea surgery: gynaecological 

Résumé

La valeur préventive du granisetron sur les nausées et vomissements postopératoires est étudiée au cours d’une étude à double aveugle qui le compare au dropéridol et à un placebo chez 100 patientes programmées pour une chirurgie gynécologique majeure. Les patientes reçoivent une seule dose de granisetron (40 μg · kg− 1, n = 25), de dropéridol (1,25 mg, n = 25; 2,5 mg, n = 25) ou une placebo (sol. physiologique, n = 25) iv sur une période de deux à cinq minutes immédiatement avant l’induction de l’anesthésie. Les effets antiémétiques de ces produits sont évalués au réveil pendant les trois premières heures et les 21 heures suivantes. Pendant 0– 3 heures après l’anesthésie, la fréquence des nausées et des vomissements est respectivement de 60%, 12%, 16% et 12% après l’administration du placebo, du granisetron, du dropéridol 1,25 mg et du dropéridol 2,5 mg. Les fréquences correspondantes entre trois et 24 heures après l’anesthésie sont de 44%, 8%, 36% et 12%. L’efficacité du granisetron pour prévenir les nausées et les vomissements est presque égale à celle du dropéridol 2,5 mg. La durée du réveil chez celles qui ont reçu dropéridol 2,5 mg est prolongée d’environ trois minutes comparativement au groupe placebo (P < 0,05) mais la somnolence postopératoire persiste chez ces patientes. Pour conclure, de granisetron en prophylaxie est supérieur au dropéridol pour prévenir les nausées et les vomissements postopératoires.

References

  1. 1.
    Madej TH, Simpson KH. Comparison of the use of domperidone, droperidol and metoclopramide in the prevention of nausea and vomiting following gynaecological surgery in day cases. Br J Anaesth 1986; 58: 879–83.PubMedCrossRefGoogle Scholar
  2. 2.
    McKenzie R, Wadhwa R, Lim NT, et al. Antiemetic effectiveness of intramuscular hydroxyzine compared with intramuscular droperidol. Anesth Analg 1981; 60: 763–8.CrossRefGoogle Scholar
  3. 3.
    Kontila K, Kauste A, Auvinen J. Comparison of domperidone, droperidol, and metoclopramide in the prevention and treatment of nausea and vomiting after balanced general anesthesia. Anesth Analg 1979; 58: 396–400.Google Scholar
  4. 4.
    Cohen SE, Woods WA, Wyner J. Antiemetic efficacy of droperidol and metoclopramide. Anesthesiology 1984; 60: 67–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Watcha MF, White PF. Postoperative nausea and vomiting. Its etiology, treatment and prevention. Anesthesiology 1992; 77: 162–84.PubMedCrossRefGoogle Scholar
  6. 6.
    Bermudez J, Boyle EA, Miner WD, Sanger GJ. The antiemetic potential of the 5-hydroxytryptamine3 receptor antagonist BRL 43694. Br J Cancer 1988; 58: 644–50.PubMedCrossRefGoogle Scholar
  7. 7.
    Fujii Y, Tanaka H, Toyooka H. Optimal anti-emetic dose of granisetron for preventing postoperative nausea and vomiting. Can J Anaesth 1994; 41: 794–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Fujii Y, Tanaka H, Toyooka H. Reduction of postoperative nausea and vomiting with granisetron. Can J Anaesth 1994; 41: 291–4.PubMedCrossRefGoogle Scholar
  9. 9.
    Leeser J, Lip H. Prevention of postoperative nausea and vomiting using ondansetron, a new, selective, 5-HT3 receptor antagonist. Anesth Analg 1991; 72: 751–5.PubMedCrossRefGoogle Scholar
  10. 10.
    Carmichael J, Cantwell BMJ, Edwards CM, et al. Apharmacokinetic study of granisetron (BRL 43694A), a selective 5-HT3 receptor antagonist: correlation with anti-emetic response. Cancer Chemother Pharmacol 1989; 24: 45–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Furue H, Oota K, Taguchi T, Niitani H. Clinical evaluation of granisetron against nausea and vomiting induced by anticancer drugs (I) optimal dose-findings study. Journal of Clinical and Therapeutic Medicine 1990; 6: 49–61.Google Scholar
  12. 12.
    Cressman WA, Plostnieks J, Johnson PC. Absorption, metabolism and excretion of droperidol by human subjects following intramuscular and intravenous administration. Anesthesiology 1973; 38: 363–9.PubMedCrossRefGoogle Scholar

Copyright information

© Canadian Anesthesiologists 1995

Authors and Affiliations

  • Yoshitaka Fujii
    • 1
  • Hiroyoshi Tanaka
    • 1
  • Hidenori Toyooka
    • 1
    • 2
  1. 1.Department of AnaesthesiaToride Kyodo General HospitalIbarakiJapan
  2. 2.Department of Anaesthesiology and Critical Care MedicineTokyo Medical and Dental University School of MedicineTokyoJapan

Personalised recommendations