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

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Abstract
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 mu g . kg(-1), 40 mu g . kg(-1) and 80 mu g . 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 mu g . kg(-1), 40 mu g . kg(-1) and 80 mu g . kg(-1), respectively. Granisetron 40 mu g . kg(-1) was as effective as 80 mu g . kg(-1) and both resulted in significant reductions of the incidence of PONV compared with placebo and granisetron 20 mu g . kg(-1) (P<0.05). No differences in the incidence of adverse events were observed among the groups. Conclusion: Granisetron 40 mu g . kg(-1) appears to be the minimum effective dose for reducing PONV in patients undergoing general anaesthesia for breast surgery. (C) Acta Anaesthesiologica Scandinavica 41 (1997).