Oral granisetron for strabismus surgery in children

Abstract

Oral granisetron for strabismus surgery in childrenPurpose: To determine the efficacy of oral granisetron in preventing postoperative vomiting (POb 0 following strabismus repair in children. Methods: In a randomized, double-blind, placebo-controlled trial, 73 pediatric patients received either placebo, 20/Jgkg-' or 40/Jg-kg -~ granisetron po 20 min before induction of anesthesia. No premedication was given, induction was with halothane and all children breathed spontaneously via a laryngeal mask airway. Maintenance was with isoflurane without the use of 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 Hg'kg -t and 40/~g-kg-' were more effective than placebo in reducing the incidence of POV during the first 24 hr (29% in both the granisetron groups vs 84% in the placebo group, P < 0.05). In addition, the number of children experiencing severe vomiting (~ 3 episodes) was reduced in the granisetron 20 Hg'kg-' and 40/~g-kg-' groups compared with placebo (4%, 8% and 48% respectively, P < 0.05). Patients in the granisetron group were discharged home earlier (I 05 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 Hg'kg -I provided effective prophylaxis against POV in children undergoing stabismus repair.

A Randomized Clinical Trial of a Single Dose of Ramosetron for the Prevention of Vomiting After Strabismus Surgery in Children

“…1 Granisetron, a serotonin receptor antagonist, reduces the incidence of POV in children undergoing strabismus surgery. 4 Ramosetron, (R)-5-[(1-methyl-3-indolyl) carbonyl]-4,5,6,7-tetrahydro-1H-benzimidazol hydrochloride (Nasea; Yamanouchi Pharmaceutical Co Ltd, Tokyo, Japan), a new antagonist of serotonin receptors, is effective for the treatment of nausea and vomiting induced by anticancer drugs. 5 Ramosetron is more potent and longer acting than granisetron for the control of cisplatin-induced emesis.…”

Management of Postoperative Nausea and Vomiting in Children

“…Limited use of difference between the granisetron groups. [126] nitrous oxide (for mask induction only), gastric emptying, and administration of combination antiemetics were believed to be Ramosetron effective methods to reduce POV in a variety of pediatric Antiemetic therapy with intravenous ramosetron 6 μg/kg was ophthalmic procedures. determined to be comparable to granisetron 40 μg/kg at the end of strabismus surgery for the prevention of POV during the early 0-…”

RETRACTED ARTICLE: Current prevention and treatment of postoperative nausea and vomiting with 5-hydroxytryptamine type 3 receptor antagonists: a review

“…The 5-HT 3 receptor antagonists commonly lack the sedative, dysphoric, and extrapyramidal effects associated with non-5-HT 3 receptor antagonists such as droperidol and metoclopramide [4]. The precise mecha- [42] have reported that oral granisetron, at a dose of 0.02 mg·kg Ϫ1 , provides effective prophylaxis against POV in pediatric patients. However, in other investigations, i.v.…”