Single-dose i.v. granisetron in the prevention of postoperative nausea and vomiting

Wilson, A. J.; Diemunsch, Pierre; Lindeque, Bennie; Scheinin, Harry; Helbo-Hansen, Hans S.; Kroeks, M. V. A. M.; Kong, K. L.

doi:10.1093/bja/76.4.515

Cited by 85 publications

(54 citation statements)

References 12 publications

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“…34 Granisetron has also been used in the management of PONV in a dose of 0.35 mg to 3 mg (IA). 44,45 Although most studies have demonstrated efficacy at 1 mg for prophylaxis, a recent study suggested it might be efficacious at lower doses. 46 For the treatment of established PONV, a dose of 0.1 mg was found to be efficacious (IA).…”

mentioning

confidence: 99%

Evidence-based management of postoperative nausea and vomiting: a review

Habib

Gan

2004

Can J Anesth/J Can Anesth

195

106

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P Pu ur rp po os se e: : To provide evidence-based guidelines for the prophylaxis and treatment of postoperative nausea and vomiting (PONV).S So ou ur rc ce e: : Literature from randomized controlled trials, systematic reviews, logistic regression analyses and expert opinion in the management of PONV.P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : The etiology of PONV is multifactorial. Patient, anesthesia, and surgery related risk factors have been identified. Universal PONV prophylaxis is not cost-effective. Identification of patients at high-risk of PONV allows targeting prophylaxis to those who will benefit most from it. No prophylaxis is needed for patients at low risk for PONV. For patients at moderate risk for PONV, prophylaxis using a single antiemetic or a combination of two agents should be considered. Double and triple antiemetic combinations should be considered for patients at high risk for PONV. Furthermore, a multimodal approach should be adopted incorporating steps to keep the baseline risk of PONV low. The optimum cost-effective approach to the management of PONV will differ between an ambulatory centre and an inpatient hospital setting. For the treatment of established PONV in patients who failed prophylaxis, patients should not receive a repeat dose of the prophylactic antiemetic. Rather, a drug acting at a different receptor should be used. Beyond six hours after surgery, patients can be treated with any of the agents used for prophylaxis, except dexamethasone and transdermal scopolamine.C Co on nc cl lu us si io on n: : PONV are common after anesthesia and surgery. We provided evidence-based guidelines for the management of this problem based on the available literature. Objectif : Énoncer des lignes de conduite fondées sur des données probantes pour la prévention et le traitement des nausées et des vomissements postopératoires (NVPO). Source : Les publications d'essais contrôlés et randomisés, les études méthodiques, les analyses de régression logistique et l'opinion d'experts sur le traitement des NVPO. Constatations principales : L'origine des NVPO est multifactorielle. Les facteurs de risque reliés au patient, à l'anesthésie et au type de chirurgie sont connus. La prévention universelle des NVPO n'est pas rentable. L'identification des patients à haut risque de NVPO permet

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confidence: 99%

Evidence-based management of postoperative nausea and vomiting: a review

Habib

Gan

2004

Can J Anesth/J Can Anesth

195

106

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“…Wilson et al [15] had compared different doses of intravenous granisetron in the prevention of PONV and found optimal dose was 1 mg. In our previous study [16] we used this dose and found it effective.…”

Section: Discussionmentioning

confidence: 99%

Randomized Double Blind Comparative Study Comparing Efficacy of Granisetron and Ondansetron for the Prophylactic Control of Postoperative Nausea and Vomiting in Patients Undergoing Middle Ear Surgery

Dua

Sethi

Sood

et al. 2012

Indian J Otolaryngol Head Neck Surg

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The objective is to evaluate the prophylactic profile, efficacy of granisetron and ondansetron to prevent postoperative nausea and vomiting (PONV) after middle ear surgery. In a randomized, double blind trial, one hundred patients undergoing middle ear surgery received either granisetron 1 mg or ondansetron 8 mg in equal volume (n = 50 for each) intravenously towards the end of surgery and before reversal of anaesthesia. A standard general anaesthetic technique was employed. Postoperatively, during the first 24 h after anaesthesia, the incidence of PONV, recovery score, time to first feeding, willingness to have the same prophylactic antiemetic drug in future and adverse events were recorded. The incidence of vomiting once (PONV score 2) was significantly less, 4% with granisetron and 22% with ondansetron (P = 0.002) respectively and the incidence of vomiting twice or more times in 30 min interval (PONV score 3) was significantly less, 8% with granisetron as compared to 34% with ondansetron (P = 0.001). The requirement of rescue antiemetic drug was significantly higher in ondansetron group, i.e. 34 vs. 8% in granisetron group (P = 0.001). The incidence of adverse events, recovery score and time to first feeding were comparable among the groups. Willingness to have the same prophylactic antiemetic drug in future was significantly high in patients receiving granisetron. Granisetron is more efficacious and desirable drug than ondansetron for reducing the incidence of PONV in patients undergoing middle ear surgery.

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“…(31) Granisetron is new antiemitic agent, however with no ideal dose defined. (32) The more common para-effects of these drugs are headaches, constipation and elevation of hepatic enzymes. Furthermore, electrocardiographic alterations may be found, although seldom and dosedependent.…”

Section: Preoperative Strategiesmentioning

confidence: 99%