Granisetron reduces post-operative vomiting in children: a dose-ranging study

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Abstract
This study was undertaken to determine the minimum effective dose of granisetron, 5-hydroxytryptamine type 3 receptor antagonist, for the prevention of post-operative vomiting in children undergoing general inhalational anaesthesia for surgery (inguinal hernia and phimosis). In a randomized, double-blind manner, 120 children, ASA physical status I, aged 4-10 years, were assigned to receive placebo (saline) or granisetron at three different doses (20 mu g kg(-1), 40 mu g kg(-1), 100 mu g kg(-1)) intravenously immediately after inhalation induction of anaesthesia (n=30 of each). A complete response, defined as no emesis and no need for another rescue antiemetic during the first 24 h after anaesthesia, occurred in 57% with placebo, 67% with granisetron 20 mu g kg(-1), 90% with granisetron 40 mu g kg(-1) and 90% with granisetron 100 mu g kg(-1) respectively (P < 0.05; overall Fisher's exact probability test). No clinically important adverse events were observed in any of the groups. Our results suggest that granisetron 40 mu g kg(-1) is the minimum effective dose for the prevention of emesis after paediatric surgery, and that increasing its dose to 100 mu g kg(-1) provides no demonstrable benefit.