RETRACTED ARTICLE: Granisetron-dexamethasone combination reduces postoperative nausea and vomiting

  • Yoshitaka Fujii
  • Hiroyoshi Tanaka
  • Hidenori Toyooka
Reports of Investigation
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Abstract

The prophylactic antiemetic efficacy of combined granisetron and dexamethasone was evaluated in a randomized doubleblind manner in 88 patients undergoing general anaesthesia for major gynaecological surgery. Immediately after recovery from anaesthesia, patients received a single dose of either placebo (saline, n = 22), granisetron (20 μg · kg− 1, n = 22), dexamethasone (8 mg, n = 22) or combined granisetron and dexamethasone (20 μg · kg− 1 and 8 mg, respectively, n = 22) iv. The treatment groups were similar for patient demography, surgical procedures, anaesthetics administered and opioids given. Postoperatively, the frequency of nausea was 32%, 23%, 27% and 5% after administration of placebo, granisetron, dexamethasone and granisetron plus dexamethasone, respectively; the corresponding frequencies of vomiting were 23%, 23%, 23% and 5%. The incidence of adverse events postoperatively were not different among the groups. It is concluded that prophylactic administration of combined granisetron and dexamethasone is effective in preventing postoperative nausea and vomiting after anaesthesia.

Key words

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

Résumé

L’efficacité prophylactique de l’association granisetrondexaméthasone est évaluée dans une étude aléatoire à double insu chez 88 patientes soumises à une chirurgie gynécologique majeure sous anesthésie générale. Immédiatement après le réveil, les patientes reçoivent en dose unique, par la voie intraveineuse soit un placebo (sol. physiologique, n = 22), soit du granisetron (20 μg · kg− 1 n = 22), soit de la déxaméthasone (8 mg, n = 22) ou une association de granisetron et de déxaméthasone (20 μg · kg− 1 et 8 mg respectivement, n = 22). Les groupes de traitement sont identiques sur le plan démographique, pour l’intervention chirurgicale, l’anesthésie et les morphiniques administrés. A la période postopératoire, la fréquence de la nausée est de 32%, 23%, 27% et 5% respectivement, après le placebo, le granisetron, la déxaméthasone et l’association granisetron-dexaméthasone: la fréquence correspondante pour les vomissements est de 23%, 23%, 23% et 5%. L’incidence des incidents postopératoires n’est pas différente entre les groupes. On conclut que l’administration de l’association granisetron-dexaméthasone est très efficace pour la prévention des nausées et vomissements postoperatoires.

References

  1. 1.
    Bermudez J, Boyle EA, Minter WD, Sanger GJ. The antiemetic potential of the 5-hydroxytryptamine3 receptor antagonist BRL 43694. Br J Cancer 1988; 58: 644–50.PubMedCrossRefGoogle Scholar
  2. 2.
    Fujii Y, Tanaka H, Toyooka H. Reduction of postoperative nausea and vomiting with granisetron. Can J Anaesth 1994; 41: 291–4.PubMedCrossRefGoogle Scholar
  3. 3.
    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
  4. 4.
    Smith DB, Newlands ES, Rustin GJS, et al. Comparison of ondanestron and ondanestron plus dexamethasone as antiemetic prophylaxis during cisplatin-containing chemotherapy. Lancet 1991; 338: 487–90.PubMedCrossRefGoogle Scholar
  5. 5.
    McKenzie R, Wadhwa RK, Uy NTL, et al. Antiemetic effectiveness of intramuscular hydroxyzine compared with intramuscular droperidol. Anesth Analg 1981; 60: 783–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Watcha MF, White PF. Postoperative nausea and vomiting. Its etiology, treatment, and prevention. Anesthesiology 1992; 77: 162–84.PubMedCrossRefGoogle Scholar
  7. 7.
    Carmichael J, Cantwell BMJ, Edwards CM, et al. A pharmacokinetic 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
  8. 8.
    Aapro MS, Plezia PM, Alberts DS, et al. Double-blind crossover study of the antiemetic efficacy of high-dose dexamethasone versus high-dose metoclopramide. J Clin Oncol 1984; 2: 466–71.PubMedGoogle Scholar

Copyright information

© Canadian Anesthesiologists 1995

Authors and Affiliations

  • Yoshitaka Fujii
    • 1
  • Hiroyoshi Tanaka
    • 1
  • Hidenori Toyooka
    • 2
  1. 1.Department of AnaesthesiologyToride Kyodo General HospitalToride City, IbarakiJapan
  2. 2.The Department of Anaesthesiology and Critical Care MedicineTokyo Medical and Dental University School of MedicineTokyoJapan

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