Superior anti-emetic efficacy of granisetron-dexamethasone combination in children undergoing middle ear surgery.
OBJECTIVE
To compare the effectiveness of granisetron and a granisetron-dexamethasone combination for the prevention of post-operative vomiting in children undergoing middle ear surgery.


METHODS
Ninety ASA physical status I or II children, aged 3-12 years, were randomly assigned to three groups of 30 each to receive a single dose of placebo (normal saline), granisetron 40 microg/kg or a combination of granisetron 40 microg/kg and dexamethasone 150 microg/kg intravenously after the induction of anaesthesia. Peri-operative anaesthetic care was standardized in all children. Post-operatively, during the first 24 h after anaesthesia, the frequencies of retching and vomiting and the incidence of adverse events were recorded. Rescue anti-emetic was administered if two or more episodes of emesis occurred. Post-operative pain was treated with morphine intravenously, followed by acetaminophen orally.


RESULTS
There were no differences between the treatment groups with regard to demographic data. A complete response (no retching/vomiting and no need for rescue anti-emetic) was achieved in 50%, 80% and 96.67% of children who received saline, granisetron and granisetron-dexamethasone, respectively (P < 0.05). Six children who received placebo and one who received granisetron alone required another rescue anti-emetic. The incidence of adverse events was comparable in the three groups.


CONCLUSIONS
The prophylactic granisetron-dexamethasone combination was more effective than granisetron alone in the prevention of post-operative emesis during the first 24 h after anaesthesia in children undergoing middle ear surgery.
Gombar
S
S
Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, #1111, Sector 32B, Chandigarh 160031, India. dr_sgombar@rediffmail.com
Kaur
J
J
Kumar Gombar
K
K
Dass
A
A
Singh
A
A
D000768:Anesthesia, General; D000932:Antiemetics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003907:Dexamethasone / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004432:Ear, Middle / Q000601:surgery*; D005260:Female; D017829:Granisetron / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy / Q000517:prevention & control*
D000932:Antiemetics; D003907:Dexamethasone; D017829:Granisetron