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A randomized, double-blind, dose-ranging, pilot study of intravenous granisetron in the prevention of postoperative nausea and vomiting in patients undergoing abdominal hysterectomy

Published online by Cambridge University Press:  15 September 2005

R. D'Angelo ,
B. Philip ,
T. J. Gan ,
A. Kovac ,
C. Hantler ,
D. Doblar ,
T. Melson ,
H. Minkowitz ,
P. Dalby  and
A. Coop
R. D'Angelo
Affiliation:
Wake Forest University School of Medicine, Winston Salem, NC, USA
B. Philip
Affiliation:
Brigham & Women's Hospital, Boston, MA, USA
T. J. Gan
Affiliation:
Duke University Medical Center, Durham, NC, USA
A. Kovac
Affiliation:
University of Kansas Medical Center, Kansas City, KS, USA
C. Hantler
Affiliation:
Washington University Medical Center, St. Louis, MO, USA
D. Doblar
Affiliation:
University of Alabama, Birmingham, AL, USA
T. Melson
Affiliation:
Helen Keller Hospital, Sheffield, AL, USA
H. Minkowitz
Affiliation:
Memorial Herman Memorial City Hospital, Houston, TX, USA
P. Dalby
Affiliation:
Magee Women's Hospital, Pittsburgh, PA, USA
A. Coop
Affiliation:
Roche Laboratories Inc, Nutley, NJ, USA
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Extract

Summary

Background and objective: Postoperative nausea and vomiting (PONV) is a frequent and unpleasant experience that may increase postoperative complications and costs. For surgical procedures with a high risk of PONV, prevention is preferable to treatment. In this study, the authors explore the dose–response relationship between granisetron administered just prior to the end of surgery and post-operative nausea and vomiting in patients undergoing abdominal hysterectomy. Methods: This was a randomized, double-blind, placebo-controlled, pilot study of post-operative nausea and vomiting prevention. Patients undergoing elective open abdominal hysterectomy requiring general anaesthesia received a single dose of granisetron 0.1, 0.2 or 0.3 mg or placebo administered approximately 15 min prior to the end of surgery. The primary efficacy end-point was the proportion of patients with no vomiting in the 0–6 h interval following medication administration. No inferential statistics were planned. Results: The proportion of patients with no vomiting episode in the 0–6 h interval after administration of study medication was higher in each granisetron treatment group (>90%) than in the placebo group (77%). Proportions of patients with no vomiting episodes in the 0–24 h interval were similar across treatment groups. Results of analyses of proportions of patients with no moderate or severe nausea episodes, proportions of those requiring rescue medication and times to first use of rescue medication suggested a treatment effect of granisetron relative to placebo in both the 0–6 and 0–24 h intervals. Similar proportions of patients in each treatment group reported at least one adverse event. Conclusions: Granisetron at doses of 0.1, 0.2 and 0.3 mg administered just prior to the end of surgery suggested a trend of improved efficacy compared to placebo in preventing postoperative nausea and vomiting in the first 6 h after abdominal hysterectomy. This pilot study did not identify a dose–response relationship.

Keywords

ANTIEMETICS, granisetronPOSTOPERATIVE NAUSEA AND VOMITING, preventionPOSTOPERATIVE COMPLICATIONSSURGICAL PROCEDURES, gynaecological, hysterectomy
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 10 , October 2005 , pp. 774 - 779
Copyright
© 2005 European Society of Anaesthesiology

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Footnotes

For the Granisetron Dose-ranging Study Group (see Appendix).

References

Gan TJ, Meyer T, Apfel CC et al. Consensus guidelines for managing postoperative nausea and vomiting. Anesth Analg 2003; 97: 62–71.Google Scholar
Fortier J, Chung F, Su J. Unanticipated admission after ambulatory surgery – a prospective study. Can J Anaesth 1998: 45: 612–619.Google Scholar
Gold BS, Kitz DS, Lecky JH, Neuhaus JM. Unanticipated admission to the hospital following ambulatory surgery. JAMA 1989; 262: 3008–3010.Google Scholar
Chung F, Mezei G. Factors contributing to a prolonged stay after ambulatory surgery. Anesth Analg 1999; 89: 1352–1359.Google Scholar
Macario A, Weinger M, Carney S, Kim A. Which clinical anesthesia outcomes are important to avoid? The perspective of patients. Anesth Analg 1999; 89: 652–658.Google Scholar
Mikawa K, Takao Y, Nishina K, Shiga M, Maekawa N, Obara H. Optimal dose of granisetron for prophylaxis against postoperative emesis after gynecological surgery. Anesth Analg 1997; 85: 652–656.Google Scholar
Wilson AJ, Diemunsch P, Lindeque BG et al. Single-dose i.v. granisetron in the prevention of postoperative nausea and vomiting. Br J Anaesth 1996; 76: 515–518.Google Scholar
Taylor AM, Rosen M, Diemunsch PA, Thorin D, Houweling PL. A double-blind, parallel-group, placebo-controlled, dose-ranging, multicenter study of intravenous granisetron in the treatment of postoperative nausea and vomiting in patients undergoing surgery with general anesthesia. J Clin Anesth 1997; 9: 658–663.Google Scholar
Gan TJ, Ginsberg B, Grant AP, Glass PS. Double-blind, randomized comparison of ondansetron and intraoperative propofol to prevent postoperative nausea and vomiting. Anesthesiology 1996; 85: 1036–1042.Google Scholar
Paxton LD, McKay AC, Mirakhur RK. Prevention of nausea and vomiting after day case gynaecological laparoscopy. A comparison of ondansetron, droperidol, metoclopramide and placebo. Anaesthesia 1995; 50: 403–406.Google Scholar