Prevention of vomiting after tonsillectomy in children: granisetron versus ramosetron.
Granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, is effective for the prevention of vomiting after tonsillectomy in children. Ramosetron (Nasea; Yamanouchi; Tokyo, Japan), another new antagonist of 5-hydroxytryptamione type 3 receptor, has more potent and longer-acting properties than granisetron (Kytril; Smith Kline Beecham, London, UK) against cisplatin-induced emesis. This study was undertaken to compare the efficacy and safety of granisetron and ramosetron for the prevention of vomiting after pediatric tonsillectomy.



Prospective, randomized, double-blinded study.



Ninety pediatric patients, aged 4 to 10 years, received intravenously granisetron 40 microg/kg or ramosetron 6 microg/kg (n = 45 each) at the end of surgery. The same standard general anesthetic technique and postoperative analgesia were used throughout. Emetic episodes and safety assessment were performed during the first 24-hour period and the next 24-hour period after anesthesia.



The rates of patients being emesis-free during the period from 0 to 24 hours after anesthesia were 89% with granisetron and 93% with ramosetron, respectively (P = .357); the corresponding rates during the period from 24 to 48 hours after anesthesia were 71% and 93%, respectively (P = .006). No clinically serious adverse events attributable to the study drugs were observed in any of the groups.



Ramosetron is a better antiemetic than granisetron for the long-term prevention of postoperative vomiting in children undergoing general anesthesia for tonsillectomy.
Fujii
Y
Y
Department of Anesthesiology, Toride Kyodo General Hospital, Tosride City, Ibaraki, Japan.
Saitoh
Y
Y
Kobayashi
N
N
D000932:Antiemetics / Q000008:administration & dosage* / Q000009:adverse effects; D001562:Benzimidazoles / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D017829:Granisetron / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D012702:Serotonin Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D014068:Tonsillectomy; D016896:Treatment Outcome; D014839:Vomiting / Q000517:prevention & control*
D000932:Antiemetics; D001562:Benzimidazoles; D017829:Granisetron; D012702:Serotonin Antagonists; C071315:ramosetron