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Preoperative oral granisetron for the prevention of vomiting following paediatric surgery

Yoshitaka Fujii1, Hiritoshi Tanaka

  • 1Department of Anaesthesiology, Toride Kyodo General Hospital, Toride City, Ibaraki, Japan. yfujii@igaku.md.tsukuba.ac.jp

Paediatric Anaesthesia
|March 21, 2002
PubMed

Insights

Preoperative oral granisetron effectively prevents vomiting in children after surgery. A 40 microg x kg(-1) dose is optimal, with higher doses showing no added benefit for preventing postoperative vomiting.

Area of Science:

  • Anesthesiology
  • Pharmacology

Background:

  • Postoperative vomiting is a common complication in pediatric surgery.
  • Granisetron, a 5-hydroxytryptamine type 3 receptor antagonist, is investigated for its antiemetic properties.

Purpose of the Study:

  • To evaluate the efficacy of preoperative oral granisetron in preventing postoperative vomiting in children undergoing general anesthesia.
  • To determine the optimal dose of granisetron for this indication.

Main Methods:

  • A randomized, double-blind, placebo-controlled trial involving 100 children (ASA physical status I, aged 4-11 years).
  • Participants received placebo or granisetron (20, 40, or 80 microg x kg(-1)) orally 60 minutes before surgery.
  • Standard general anesthetic technique was employed for all participants.

Main Results:

  • The percentage of emesis-free patients at 0-6 hours post-anesthesia was 56% (placebo), 64% (20 microg x kg(-1)), 88% (40 microg x kg(-1)), and 92% (80 microg x kg(-1)).
  • Significant improvements in preventing vomiting were observed with 40 microg x kg(-1) (P=0.027) and 80 microg x kg(-1) (P=0.01) compared to placebo.
  • Emesis rates at 6-24 hours post-anesthesia showed similar trends, with 40 and 80 microg x kg(-1) doses being significantly effective (P=0.02).
  • No serious adverse events were reported in any treatment group.

Conclusions:

  • Preoperative oral granisetron at 40 microg x kg(-1) is an effective prophylactic measure against postoperative vomiting in pediatric patients.
  • Increasing the dose to 80 microg x kg(-1) did not provide additional significant benefits in preventing vomiting.
  • Granisetron is a safe option for managing postoperative nausea and vomiting in pediatric surgical patients.
Abstract

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