title: Antiemetic prophylaxis in thyroid surgery: a randomized, double-blind comparison of three 5-HT3 agents.
abstract: OBJECTIVE
  The aim of this double-blind randomized study was to compare the antiemetic efficacy of three 5-hydroxytryptamine type 3 antagonists in terms of the incidence and intensity of postoperative nausea and vomiting (PONV) in a homogenous group of female patients undergoing thyroidectomy.
  
  
  METHODS
  The study cohort consisted of 203 American Society of Anesthesiologists PS I-II female patients randomized into four groups to receive at induction of anesthesia an intravenous (IV) bolus of 5 ml solution of one of the following: normal saline (placebo), granisetron 3 mg, ondansetron 4 mg, or tropisetron 5 mg. Nausea and vomiting were evaluated at five time points: during the first hour in the postanesthesia care unit (PACU) and 6, 12, 18, and 24 h postoperatively. Nausea intensity was measured using a visual analogue scale score (0-10).
  
  
  RESULTS
  Patients in the placebo group displayed a high incidence of nausea in the PACU and at 6, 12, and 18 h postoperatively (44, 60, 50, and 34%, respectively) and of vomiting (26, 42, 30 and 10%). The administration of granisetron reduced significantly the incidence of nausea at 6, 12, and 18 h (26, 18, and 2%, respectively) and vomiting at 6 and 12 h (10 and 6%, respectively). Ondansetron reduced significantly the incidence of nausea and vomiting only at 6 h postoperatively (28 and 12%, respectively). The administration of tropisetron did not affect the incidence of PONV compared to placebo.
  
  
  CONCLUSIONS
  Among the female patients of this study undergoing thyroid surgery, granisetron 3 mg provided the best prophylaxis from PONV. Ondansetron 4 mg was equally effective, but its action lasted only 6 h, whereas tropisetron 5 mg was found ineffective.
authors: Department of Anesthesiology, University Hospital of Heraklion, Heraklion, Crete, Greece.
authors: Maria
authors: M
authors: Metaxari
authors: Alexandra
authors: A
authors: Papaioannou
authors: Anastasios
authors: A
authors: Petrou
authors: Aikaterini
authors: A
authors: Chatzimichali
authors: Elena
authors: E
authors: Pharmakalidou
authors: Helen
authors: H
authors: Askitopoulou
mesh_terms: D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D017829:Granisetron / Q000627:therapeutic use*; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017294:Ondansetron / Q000627:therapeutic use*; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology / Q000517:prevention & control*; D011229:Preanesthetic Medication; D058831:Serotonin 5-HT3 Receptor Antagonists / Q000627:therapeutic use*; D013965:Thyroidectomy; D000077526:Tropisetron; D055815:Young Adult
chemical_list: D000932:Antiemetics; D017829:Granisetron; D007211:Indoles; D017294:Ondansetron; D058831:Serotonin 5-HT3 Receptor Antagonists; D000077526:Tropisetron