A randomized blinded study of the incidence of postoperative nausea and vomiting in women after major gynecologic laparoscopic surgery.
OBJECTIVE
To estimate the incidence of postoperative nausea and vomiting (PONV) in women undergoing major gynecologic laparoscopic surgery with an expected surgical duration exceeding 1 hour and anticipated overnight hospitalization.


METHODS
Randomized, double-blind, placebo-controlled study.


METHODS
This study was set at a university hospital.


METHODS
One hundred forty female patients with an American Society of Anesthesiology (ASA) physical status I or II and scheduled for gynecologic inpatient laparoscopic surgery.


METHODS
Patients were randomly assigned to receive 1 mg granisetron (Group A, n=70), or saline solution (Group B, n=70) intravenously after induction of general anesthesia.


RESULTS
The endpoints were evaluated by the following parameters: the incidence of PONV, episodes of nausea, retching, vomiting, rescue antiemetics, and complete response. Patients were closely observed for 24 hours after administration of the study drug. The two groups were generally well balanced in terms of demographic variables. The surgical period was longer in the granisetron group compared with the saline solution group. The total incidence of PONV was 41/70 (59%) in patients who underwent inpatient gynecologic laparoscopic surgery when no prophylactic antiemetic was given. Administration of granisetron decreased the incidence of PONV (29/70 [41%] vs 41/70 [59%], p<.05), the incidence of vomiting (18/70 [26%] vs 31/70 [44%], p<.05), and the proportions of patients requiring rescue antiemetics (14/70 [20%] vs 47/70 [67%], p<.01), but these results were not comparable to other studies.


CONCLUSIONS
A long surgical period may have great impact on the PONV in women who undergo gynecologic laparoscopic surgery, which implies the need for skilled gynecologic laparoscopists.
Tseng
Ling-Hong
LH
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Taoyuan, Taiwan, Republic of China.
Liou
Shiue-Chin
SC
Chang
Ting-Chang
TC
Tsai
Shih-Chang
SC
Soong
Yung-Kuei
YK
Wong
Shu-Yam
SY
D000328:Adult; D000932:Antiemetics / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D017829:Granisetron / Q000627:therapeutic use*; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology* / Q000517:prevention & control*; D013624:Taiwan
D000932:Antiemetics; D017829:Granisetron