Abstract
Purpose
The purpose of this study was to compare the effectiveness of granisetron, metoclopramide and placebo in reducing the frequencies of retching and vomiting in children who had undergone strabismus repair and tonsillectomy with or without adenoidectomy.
Methods
In a randomized, double-blind study, 70 healthy subjects, 4–10 yr of age, were given a single dose of either placebo (saline, n = 24), metoclopramide 0.25 mg · kg−1 (n = 23) granisetron 40 μg · kg−1 (n = 23) iv over two to five minutes after the induction of anaesthesia. All subjects received inhalation anaesthesia with sevoflurane and nitrous oxide in oxygen. Rescue antiemetics were administered if two or more episodes of vomiting occurred. Acetaminophen pr or pentazocine iv was given as needed for postoperative pain. All subjects remained in hospital for two days. During the first three and the next 21 hr after anaesthesia, the frequencies of retching and vomiting were recorded by nursing staff.
Results
There was no difference among groups with regard to demographic characteristics, surgical procedures, anaesthetics administered, postoperative managements, or adverse effects. During 0–3 hr after anaesthesia, the frequencies of retching and vomiting were: placebo 62%, metoclopramide 22% and granisetron 13% (P < 0.05). The corresponding frequencies during 3–24 hr after anaesthesia were: placebo 50%, metoclopramide 39% and granisetron 13% (P < 0.05). Four children who had received placebo and three who had received metoclopramide required another rescue antiemetic.
Conclusion
Granisetron 40 μg · kg−1 is more effective than either metoclopramide or placebo in reducing the frequencies of postoperative retching and vomiting during the first 24 hr after anaesthesia in children who have undergone strabismus surgery and tonsillectomy with or without adenoidectomy.
Résumé
Objectif
Comparer l’efficacité du granisetron, de la métoclopramide et d’un placebo sur la réduction de la fréquence des efforts pour vomir et des vomissements chez des enfants opérés pour strabisme et amygdalectomie avec ou sans adénoïdectomie.
Méthodes
Au cours d’une étude aléatoire, en double aveugle, 70 enfants en bonne santé âgés de 4 à 10 ans ont reçu en une seule dose, soit un placebo (n = 24), soit de la métaclopramide 0,25 mg · kg−1 (n = 23), soit du granisetron 40 μg · kg−1 (n = 23) iv sur une période de deux à cinq minutes après l’induction de l’anesthésie. L’anesthésie était toujours constituée de sévoflurane par inhalation avec du protoxyde d’azote en oxygène. Des antiémétiques de sauvetage ont été administrés si deux épisodes ou plus de vomissements survenaient. Tous les sujets sont demeurés à l’hôpital pendant deux jours. À la troisième heure et à la vingt et unième heure après l’anesthésie, la fréquence des efforts pour vomir et des vomissements était enregistrée par le personnel infirmier.
Résultats
Les caractéristiques démographiques, les interventions, les anesthésiques administrés, les soins postopératoire et les complications ont été les même pour tous les groupes. Pendant les trois premières heures qui ont suivi l’anesthésie, la fréquence des effets pour vomir et des vomissements était comme suit: placebo 62%, métoclopramide 22% et granisetron 13% (P < 0,05). Les fréquences correspondantes pendant la période s’étendant de 3 à 24 h après l’anesthésie étaint: placebo 50%, métoclopramide 39% et granisetron 13% (P < 0,05). Quatre enfant qui avaient reçu le placebo et trois de ceux qui avaient reçu la métoclopramide ont eu besoin d’un antiémétique de sauvetage.
Conclusion
Le granisetron 40 μ · kg−1 est plus efficace que la métoclopramide et le placebo pour réduire la fréquence des efforts et des vomissements postopératoires pendant les 4 h qui suivent l’anesthésie chez des enfants opérés pour strabisme et amygdalectomie avec ou sans adénoïdectomie.
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This article has been retracted due to two reasons: Many variables reported in the studies are exceedingly unlikely. The author’s institution is not able to attest the integrity of the study and/or the data conducted under its auspices.
An erratum to this article can be found online at http://dx.doi.org/10.1007/s12630-012-9827-0.
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Fujii, Y., Toyooka, H. & Tanaka, H. RETRACTED ARTICLE: Antiemetic efficacy of granisetron and metoclopramide in children undergoing ophthalmic or ENT surgery. Can J Anaesth 43, 1095–1099 (1996). https://doi.org/10.1007/BF03011834
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DOI: https://doi.org/10.1007/BF03011834