Retracted: Prophylactic anti‐emetic therapy with granisetron, droperidol and metoclopramide in female patients undergoing middle ear surgery

Abstract

SummaryThe efficacy of granisetron, droperidol and metoclopramide for the prevention of postoperative nausea and vomiting in female patients undergoing middle ear surgery was compared. In a randomised, double-blind study, 180 patients received granisetron 40 mg.kg ¹1, droperidol 20 mg.kg ¹1 or metoclopramide 0.2 mg.kg ¹1 given intravenously immediately before induction of anaesthesia (n ¼ 60 for each). A standardised general anaesthetic technique was employed throughout. A complete response, defined as no postoperative nausea and vomiting and no need for another rescue anti-emetic, during the first 3 h after anaesthesia was achieved in 83%, 58% and 55% of patients who had received granisetron, droperidol and metoclopramide, respectively. The corresponding incidence during the next 21 h after anaesthesia was 85%, 54% and 47% (p < 0.05). No clinically important adverse effects were observed in any of the groups. We conclude that prophylactic therapy with granisetron is superior to droperidol or metoclopramide in the prevention of postoperative nausea and vomiting after middle ear surgery. Postoperative nausea and vomiting (PONV) are distressing and frequent adverse events after general anaesthesia and surgery [1] and patients who undergo middle ear surgery may be especially at risk of experiencing these problems. In the absence of any anti-emetic treatment, the incidence of PONV following middle ear surgery ranges from 62% to 80% [2,3]. We have recently demonstrated that granisetron, a selective 5-hydroxytryptamine type 3 (5-HT3) receptor antagonist, reduces the incidence of PONV after middle ear surgery [4]. However, there have been no studies to compare its efficacy with commonly used and well-established anti-emetics in the prevention of PONV after middle ear surgery. This study was undertaken to assess the efficacy of granisetron, droperidol and metoclopramide, in a randomised, double-blind fashion, for the prevention of PONV in female patients undergoing middle ear surgery. MethodsApproval of our institutional review board and informed consent from patients were obtained. One hundred and eighty women, ASA physical status 1, aged 20-68 years and scheduled for middle ear surgery (tympanoplasty or mastoidectomy) were recruited into the study. Patients who had gastrointestinal diseases, those who had a history of motion sickness and/or previous PONV, those who were pregnant or menstruating, or those who had taken anti-emetics within 24 h before surgery were not studied.Patients were randomly assigned to one of three groups (n ¼ 60 for each) to receive a single dose of either granisetron 40 mg.kg

Randomized Double Blind Comparative Study Comparing Efficacy of Granisetron and Ondansetron for the Prophylactic Control of Postoperative Nausea and Vomiting in Patients Undergoing Middle Ear Surgery

“…Our study coincides with the findings of various studies of Fuji et al [6,7,[10][11][12] where complete response rate were between 78 and 86% with varying doses of granisetron having the PONV 14-22%. PONV was much less in our study although we had used granisetron in lesser dose as compared to these studies.…”

Outpatient Tympanomastoidectomy

“…The majority of patients in our study received droperidol. Other studies 10 have reported rates of 42% for PONV when droperidol is used in a preemptive fashion, a rate similar to the 50% we observed in this study. Use of prophylactic antiemetic drugs, including 5-HT 3 receptor antagonists, seems to be ineffective in patients with a history of motion sickness or previous PONV.…”

Placebo-controlled comparison of dolasetron and metoclopramide in preventing postoperative nausea and vomiting in patients undergoing hysterectomy

“…Despite the higher dose of metoclopramide (20 mg), no patient in our study showed such undesirable effects. Some authors reported on a lower antiemetic potency of metoclopramide compared with the 5‐HT 3 antagonists ondansetron and granisetron, respectively [26–28]. Others found no advantage of 5‐HT 3 antagonists compared with metoclopramide [21].…”