The combination (granisetron plus dexamethasone) further increases the chance of complete response than granisetron alone. Therefore, the combination might be considered clinically relevant in a high risk setting.

Objective(s) The objective of this study was to evaluate the efficacy and safety of granisetron (5HT 3 receptor antagonist) on the incidence of nausea and vomiting in cesarean deliveries under spinal anesthesia. Method(s) In the randomized, double-blind study, 80 parturients received granisetron 40 lg/kg or placebo (n = 40 each) intravenously, immediately after clamping of the fetal umbilical cord. Nausea, vomiting, and adverse events were then observed for 24 h after administration of spinal anesthesia. Results A complete response (defined as no postoperative nausea and vomiting) during 0-4 h after administration of spinal anesthesia was achieved in 80 % of patients with granisetron and in 45 % of patients with placebo. The corresponding incidences during (4-24 h) were 82.5 and 55 % (P value\0.05). No difference in adverse events was observed in any of the groups. Conclusion(s) Prophylactic use of granisetron is effective for preventing emetic episodes during spinal anesthesia for cesarean delivery.