THE ANTIEMETIC EFFICACY OF PROPHYLACTIC GRANISETRON IN GYNECOLOGIC SURGERY

Postoperative nausea and vomiting are common after recovery from anest hesia. We examined the prophylactic effect of granisetron on postopera tive nausea and vomiting in 120 female patients (ASA physical status I ) undergoing gynecologic surgery. They were randomly allocated to one of three groups (n = 40 for each): saline (as a control), granisetron 20 mu g/kg, and granisetron 40 mu g/kg. Saline or granisetron was give n intravenously (IV) over 5 min approximately 30 min before the end of anesthesia. Nausea, vomiting, and safety assessments were performed d uring the 24-h recovery period. For the 24-h period after surgery, the number of emesis-free patients was significantly larger in the granis etron groups than in the control group (83%, 78%, and 20% of patients receiving granisetron 20 mu g/kg and 40 mu g/kg, and saline, respectiv ely). Granisetron at both doses also was superior to the control for t he prevention of over the 24-h study period (nausea visual analog scal es at 24-h postsurgery: 49 mm, 17 mm, and 18 mm in the control, granis etron 20 mu g/kg, and granisetron 40 mu g/kg groups, respectively). Fe wer patients received ''rescue'' antiemetics in the granisetron groups than in the control group (10%, 10%, and 43% of patients in granisetr on 20 mu g/kg and 40 mu g/kg, and the control groups, respectively). T he adverse events in the granisetron groups were similar to those in t he control group. The administration of granisetron had no significant effect on vital signs or clinical laboratory test profiles. Granisetr on given at 20 or 40 mu g/kg IV during anesthesia appears to be a simp le, effective, and safe method for preventing postoperative nausea and vomiting.