Oral granisetron for strabismus surgery in children

Purpose: To determine the efficacy of oral granisetron in preventing postop erative vomiting (POV) following strabismus repair in children. Methods: In a randomized, double-blind, placebo-controlled trial, 73 pediat ric patients received either placebo, 20 mu g.kg(-1) or 40 mu g.kg(-1) gran isetron Po 20 min before induction of anesthesia. No premedication was give n, induction was with halothane and all children breathed spontaneously via a laryngeal mask airway, Maintenance was with isoflurane without the use o f opioids. Ketorolac and acetaminophen were used for analgesia, The number of episodes and the severity of vomiting and retching were recorded for the first 24 hr postoperatively, as was the use of rescue antiemetics. Results: Granisetron 20 mu g.kg(-1) and 40 mu g.kg(-1) were more effective than placebo in reducing the incidence of POV during the first 24 hr (29% i n both the granisetron groups vs 84% in the placebo group, P < 0.05). In ad dition, the number of children experiencing severe vomiting (greater than o r equal to 3 episodes) was reduced in the granisetron 20 mu g.kg(-1) and 40 mu g.kg(-1) groups compared with placebo (4%, 8% and 48% respectively, P < 0.05). Patients in the granisetron group were discharged home earlier( 105 min vs 124 min, P = 0.04). There was no difference in the incidence of POV between the two granisetron groups. Conclusion: Preoperative oral granisetron in a dose of 20 mu g.kg(-1) provi ded effective prophylaxis against POV in children undergoing stabismus repa ir.