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Preoperative oral antiemetics for reducing postoperative vomiting after tonsillectomy in children: granisetron versus
1Department of Anesthesiology, University of Tsukuba Institute of Clinical Medicine, Tsukuba City, Ibaraki, Japan.
Insights
Granisetron is more effective than perphenazine for preventing postoperative vomiting in children undergoing tonsillectomy. This randomized trial found superior complete response rates with granisetron, with no serious adverse events reported.
Area of Science:
- Pediatric Anesthesiology
- Pharmacology
- Surgical Outcomes
Background:
- Postoperative vomiting is a common complication in pediatric tonsillectomy.
- Effective antiemetic strategies are crucial for improving patient recovery and satisfaction.
Purpose of the Study:
- To compare the efficacy of oral granisetron versus perphenazine in preventing postoperative vomiting in children undergoing tonsillectomy with or without adenoidectomy.
- To evaluate the safety profile of both antiemetics in this pediatric population.
Main Methods:
- A prospective, randomized, double-blinded trial involving 100 pediatric patients (ASA physical status I, aged 4-10 years).
- Patients received either granisetron (40 microg/kg) or perphenazine (70 microg/kg) orally one hour before surgery.
- Standard general anesthetic techniques were employed.
Main Results:
- Granisetron demonstrated a significantly higher rate of complete response (no emesis, no rescue medication) compared to perphenazine.
- Complete response rates at 0-3 hours post-anesthesia were 86% for granisetron vs. 60% for perphenazine (P < 0.05).
- Complete response rates at 3-24 hours post-anesthesia were 86% for granisetron vs. 62% for perphenazine (P < 0.05).
Conclusions:
- Preoperative oral granisetron is a more effective antiemetic than perphenazine for preventing postoperative vomiting in children undergoing tonsillectomy/adenoidectomy.
- Both medications were well-tolerated, with no serious adverse events observed.
- Granisetron offers a superior option for managing postoperative nausea and vomiting in this surgical context.
Unlabelled:
In a prospective, randomized, double-blinded trial, we evaluated the efficacy of two antiemetics given orally, granisetron and perphenazine, for preventing postoperative vomiting after tonsillectomy with or without adenoidectomy in children. One hundred pediatric patients, ASA physical status I, aged 4-10 yr, received either granisetron 40 microg/kg or perphenazine 70 microg/kg (n = 50 each) orally 1 h before surgery. We used a standard general anesthetic technique. The rate of complete response, defined as no emesis and no need for rescue antiemetic medication, during 0-3 h after anesthesia was 86% with granisetron and 60% with perphenazine; the corresponding rate 3-24 h after anesthesia was 86% and 62%, respectively (P < 0.05). No serious adverse events were observed in any of the groups. In conclusion, preoperative oral granisetron is more effective than perphenazine for preventing postoperative vomiting in children undergoing tonsillectomy with or without adenoidectomy.
Implications:
We compared the efficacy of granisetron and perphenazine given orally for preventing postoperative vomiting after tonsillectomy with or without adenoidectomy in children. Preoperative oral granisetron was more effective than perphenazine.