Granisetron versus granisetron/dexamethasone combination for the treatment of nausea, retching, and vomiting after major gynecologic surgery: a randomized, double-blind study.
BACKGROUND
Granisetron, a selective 5-hydroxytryptamine3 antagonist, is effective for the treatment of patients with postoperative nausea and vomiting. Dexamethasone decreases chemotherapy-induced emesis when added to an antiemetic regimen.


OBJECTIVE
This study compared the efficacy of granisetron alone with granisetron/dexamethasone combination for the treatment of nausea and vomiting after major gynecologic surgery.


METHODS
In this randomized, double-blind study, patients who were experiencing emetic symptoms during 0 to 3 hours after the end of anesthesia administration received granisetron 40 microg/kg i.v. either alone or in combination with dexamethasone 8 mg. Patients then were observed for 24 hours after study drug administration, with emetic episodes recorded and tolerability assessments performed by nursing staff blinded to treatment.


RESULTS
A total of 120 women were enrolled (n = 60 in each treatment group; mean [SD] age in the granisetron group, 44 [9] years [range, 23-63 years]; combination group, 45 [8] years [range, 21-65 years]). No significant differences in patient demographic characteristics were found between the 2 treatment groups. However, the percentage of patients free of emetic symptoms (nausea, retching, vomiting) was higher in the granisetron/dexamethasone combination group than in the granisetron group (95.0% and 80.0%, respectively; P = 0.012). No clinically serious adverse events attributed to the study drugs were observed in either group.


CONCLUSIONS
In this study, the granisetron/dexamethasone combination was more effective than was granisetron alone for the management of nausea and vomiting during 0 to 3 hours after anesthesia in women undergoing major gynecologic surgery.
Fujii
Yoshitaka
Y
Department of Anesthesiology, Toride Kyodo General Hospital, Toride City, Ibaraki, Japan. yfujii@igaku.md.tsukuba.ac.jp
Tanaka
Hiroyoshi
H
D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000009:adverse effects; D000932:Antiemetics / Q000627:therapeutic use*; D003907:Dexamethasone / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D017829:Granisetron / Q000627:therapeutic use*; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D009325:Nausea / Q000188:drug therapy* / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D014839:Vomiting / Q000188:drug therapy* / Q000209:etiology
D000932:Antiemetics; D003907:Dexamethasone; D017829:Granisetron