Prophylactic antiemetic efficacy of granisetron in patients with and without previous postoperative emesis

To evaluate the efficacy of granisetron, a selective antagonist of 5-hydroxytryptamine type 3 receptors, in the prevention of PONV in patients with and without previous postoperative emesis undergoing general anaesthesia for major gynaecological surgery.

In a randomized, double-blind, placebo-controlled trial of 90 women with (n = 40) and without (n = 50) a history of PONV, the patients received either granisetron (40 micrograms.kg-1) or placebo (saline) iv immediately before induction of anaesthesia. The same standard general anaesthetic technique, which consisted of isoflurane in nitrous oxide and oxygen and avoided opioids, was used. Nausea, vomiting and safety assessments were performed during the first 24 hr after anaesthesia.

The incidence of PONV was 70% and 25% after administration of placebo and granisetron in patients with previous PONV (P < 0.05), and was 40% and 8% in patients without it, respectively (P < 0.05). The incidence of adverse events postoperatively were not different among the treatment groups.

Granisetron 40 micrograms.kg-1 given prior to anaesthesia reduces the incidence of PONV in patients with a history of PONV as well as in patients without it.