Granisetron reduces postoperative nausea and vomiting throughout menstrual cycle

Abstract

Granisetron reduces postoperative nausea and vomiting throughout menstrual cyclePurpose: The incidence of postoperative nausea and vomiting (PONV) is influenced by menstruation. This study was undertaken to assess the efficacy of granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, for preventing PONV in patients during two different phases of menstrual cycle. Methods: One hundred twenty female patients undergoing general anaesthesia for major gynaecological surgery were divided according to the phase of menstrual cycle into two groups: day one to eight (menstrual) and day nine to end of the cycle (non-menstrual) groups. In a randomized, double-blind manner, the patients received placebo (saline) or 40/./g.kg -I granisetron iv immediately before the induction of anaesthesia. All patients received a standardized general and epidural anaesthesia and epidural morphine plus bupivacaine for postoperative analgesia. The incidence of PONV and other adverse events was recorded dunng the first 24 hr after anaesthesia.Results: The treatment groups were similar with respect to patient demographics, types of surgery, anaesthetics administered and analgesics used postoperatively. The incidence of PONV was 72% and 32% in patients during menstruation receiving placebo or granisetron (P < 0.05), and was 46% and 2096 in those during non-menstruation, respectively (P < 0.05). No differences in the incidence of other adverse events were observed among the groups.Conclusion: Granisetron was effective in reducing the incidence of PONV in both phases of the menstrual cycle studied. Objectif: Les menstruations influencent I'incidence des nausEes et des vomissements postop&atoires (NVPO).Cette Etude visait ~ Evaluer I'efficacitE du granisetron, un antagoniste du r&epteur de la 5-hydroxytryptamine de type 3, administrE pour la prevention des NVPO pendant [es diffErentes phases du cycle menstruel.M&hodes : Cent vingt patientes programmEes pour une chirurgie gynEcologique majeure sous anesth&ie gEn&ale ont EtE rEparties en deux groupes dEterminEs par la phase de leur cycle menstruel: du premier au huiti~me jour (,~menstruel~) et du neuvi~me jour ~ la fin du cycle (anon menstruel~). En double aveugle et alEatoirement, les patientes ont re~u un placebo (du sol. phys.) ou 40/ag'kg -t de granisetron iv immEdiatement avant I'induction de I'anesth&ie. Toutes les patientes ont re~:u une anesthEsie gEn&ale ou Epidurale standard et de la morphine Epidurale avec ajout de bupivaca'ine pour ranalgEsie postol~ratoire. ILincidence des NVPO et des autres incidents a ErE enregistrEe pendant 24 h aprEs I'anesthEsie.REsultats : Les deux groupes Etaient identiques sur le plan de la d~mographie, du type de chirurgie, de I'anesth~sie et des analg&iques administrEs en postop&atoire. ILincidence des NVPO a ErE respectivement de 72% et de 32% darts le groupe menstruel recevant le placebo et le granisetron (P < 0,05) et de 46% et de 20~ darts le groupe non menstruel (P < 0,05). Eincidence des complications a ErE la mEme dans les deux groupes.C...

Patient Sex and its Influence on General Anaesthesia

“…Here, the incidence of nausea was found to be greatest during the follicular phase compared to the luteal phase, with the peak incidence occurring during day five of the menstrual cycle 163 . This observation was confirmed in another study involving women undergoing gynaecological laparoscopy and laparotomy 164 . The greater incidence of PONV in women has been reported in a wide range of anaesthetic regimens and surgical procedures 6,11,156,157,163 .…”

Menstruationszyklus in der postoperativen Phase

“…Mit einer systematischen computergestützten Literaturrecherche der Medline Literaturdatenbank und der Cochrane-Library wurden Studien gesucht, die Informationen über das Auftreten von PONV zu bestimmten Phasen des In einer Reihe von Originalpublikationen [2-4, 8,12,13,16,18,19] wie auch in Übersichtsarbeiten [17] Objective. Several studies suggest that the menstrual cycle has an impact on postoperative nausea and vomiting (PONV).However, many studies report inconsistent results.…”

“…q Es konnten keine Absolutzahlen extrahiert werden [11,15]. [13], Metoclopramid [9], oder 5-HT 3 -Antagonisten [8,9,10,11,14]) durchgeführt wurde (s. Tabelle 1 ).…”