Prophylactic antiemetic therapy with granisetron-dexamethasone combination in women undergoing breast surgery.
BACKGROUND
Dexamethasone decreases chemotherapy-induced emesis when added to an antiemetic regimen. This study was undertaken to evaluate the efficacy of granisetron-dexamethasone combination for the prevention of postoperative nausea and vomiting (PONV) in female patients undergoing general anaesthesia for breast surgery.


METHODS
In a randomized, double-blind manner, 135 ASA I patients, aged 40-65 years, were assigned to receive placebo (saline), granisetron 40 micrograms.kg-1 or granisetron 40 micrograms.kg-1 plus dexamethasone 8 mg i.v. (n = 45 of each) immediately before the induction of anaesthesia. A standard general anaesthetic technique and postoperative analgesia were used. The PONV and safety assessments were performed continuously during the first 3 h (0-3 h) and the next 21 h (3-24 h) after anaesthesia.


RESULTS
A complete response, defined as no PONV and no administration of rescue antiemetic medication, during 0-3 h after anaesthesia was 51%, 82% and 96% in patients who had received placebo, granisetron and granisetron-dexamethasone combination, respectively; the corresponding incidence during 3-24 h after anaesthesia was 56%, 84% and 98% (P < 0.05; overall Fisher's exact probability test). No clinically important adverse events were observed in any of the groups.


CONCLUSIONS
Prophylactic use of granisetron-dexamethasone combination is more effective than granisetron alone for the prevention of PONV after breast surgery.
Fujii
Y
Y
Department of Anaesthesiology, Toride Kyodo General Hospital, Ibaraki, Japan.
Tanaka
H
H
Toyooka
H
H
D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D017829:Granisetron / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D009325:Nausea / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D014839:Vomiting / Q000517:prevention & control*
D000932:Antiemetics; D003907:Dexamethasone; D017829:Granisetron