Effective dose of granisetron in the reduction of nausea and vomiting after breast surgery.

BACKGROUND

Prophylactic use of granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, reduces the incidence of nausea and vomiting after breast surgery. This study was undertaken to determine the minimum effective dose of granisetron in the reduction of postoperative nausea and vomiting (PONV) in patients undergoing general anaesthesia for breast surgery.

METHODS

In a randomized, double-blind manner, 120 female patients aged 42-66 years were assigned to receive either placebo (saline) or granisetron in a dose of 20 micrograms.kg-1, 40 micrograms.kg-1 and 80 micrograms.kg-1 i.v. immediately before the induction of anaesthesia. A standard general anaesthetic technique was employed throughout. The PONV and safety assessments were performed continuously during the first 24 h after anaesthesia.

RESULTS

There were no significant differences among the groups with regard to patient demographics, surgical procedures, anaesthetics administered and analgesics given. The incidence of PONV was 47%, 43%, 17% and 17% after administration of placebo and granisetron 20 micrograms.kg-1, 40 micrograms.kg-1 and 80 micrograms.kg-1, respectively. Granisetron 40 micrograms.kg-1 was as effective as 80 micrograms.kg-1 and both resulted in significant reductions of the incidence of PONV compared with placebo and granisteron 20 micrograms.kg-1 (P < 0.05). No differences in the incidence of adverse events were observed among the groups.

CONCLUSION

Granisetron 40 micrograms.kg-1 appears to be the minimum effective dose for reducing PONV in patients undergoing general anaesthesia for breast surgery.