Prevention of postoperative nausea and vomiting in patients undergoing laparoscopic bariatric surgery--granisetron alone vs granisetron combined with dexamethasone/droperidol.
OBJECTIVE
Laparoscopic bariatric surgeries are associated with an appreciably high rate of postoperative nausea and vomiting. This study was designed to compare the effectiveness of granisetron either alone or in combination with droperidol or dexamethasone, for the prevention of post operative nausea and vomiting (PONV) in patients undergoing laparoscopic bariatric surgeries.


METHODS
In a randomized, double-blind, placebo-controlled trial, 120 patients received either Granisetron 1 mg, Granisetron 1 mg plus Droperidol 1.25 mg, Granisetron 1 mg plus Dexamethasone 8 mg or Placebo (saline), intravenously immediately before induction of anesthesia. Perioperative anesthetic care was standardized in all patients. Patients were then observed for 24 hours after administration of the study drugs.


RESULTS
The incidence of PONV was 30% with granisetron alone, 30% with granisetron plus droperidol, 20%, with granisetron plus dexamethanone, and 67% with placebo. (P < 0.05; overall Fisher's exact probability test). The incidence of adverse events was not different among the 4 groups.


CONCLUSIONS
Graniserton is effective and safe drug for reducing the incidence of PONV in patients undergoing bariatric surgeries, and becomes highly effective when combined with dexamethasone.
Moussa
Ashraf A
AA
National Liver Institute, Menofia University, Egypt. ashrafmoussa91@hotmail.com
Oregan
Patrick J
PJ
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000768:Anesthesia, General / Q000379:methods; D000932:Antiemetics / Q000009:adverse effects / Q000627:therapeutic use; D050110:Bariatric Surgery / Q000009:adverse effects*; D003907:Dexamethasone / Q000627:therapeutic use*; D004311:Double-Blind Method; D004329:Droperidol / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D017829:Granisetron / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage; D016896:Treatment Outcome
D000932:Antiemetics; D003907:Dexamethasone; D004329:Droperidol; D017829:Granisetron; D012965:Sodium Chloride