Abstract
Purpose
Dexamethasone decreases chemotherapy-induced emesis when added to antiemetic regimens. This study was designed to compare the effectiveness of granisetron and dexamethasone with granisetron alone in the prevention of postoperative vomiting after strabismus repair, tonsillectomy with or without adenoidectomy in children.
Methods
In a randomized, double-blind study, 60 healthy children, 4–10 yr of age, received either granisetron 40 μg · kg−1 and saline (Group S) or granisetron 40 μg · kg−1 and dexamethasone 4 mg (Group D) iv immediately after the induction of anaesthesia. All subjects received anaesthetics consisting of sevoflurane and nitrous oxide in oxygen. Postoperative pain was treated with acetaminophen pr or pentazocine iv. Postoperatively, during the first 24 hr after anaesthesia, the frequencies of retching and vomiting, and the incidence of adverse events were recorded by nursing staff.
Results
There were no differences between the treatment groups with regard to demographics, surgical procedure, anaesthetic administered or analgesics used for postoperative pain. The frequency of the symptoms was 27% and 7% in Groups S and D, respectively (P < 0.05). The incidence of adverse events was comparable in the two groups.
Conclusion
The prophylactic administration of granisetron and dexamethasone was more effective than granisetron alone in the prevention of postoperative vomiting in paediatric subjects undergoing strabismus repair, tonsillectomy and adenoidectomy.
Résumé
Objectif
La dexaméthasone diminue les vomissements provoqués par ta chimiothérapie lorsqu’on l’associe aux médications antiémétiques. Cette étude visait à comparer l’efficacité de l’association dexaméthasone-granisetron et du granisetron seul administrés pour la prévention des vomissements postopératoires consécutifs à la correction de strabisme et à l’amygdalectomie avec ou sans adénoïdectomie chez l’enfant.
Méthodes
L’étude était aléatoire et en double aveugle. Elle groupait 60 enfants âgés de 4 à 10 ans qui avaient reçu soit granisetron 40 μg · kg−1 avec du sol. phys. (groupe S) ou granisetron 40 μg · kg−1 avec dexaméthasone 4 mg (groupe D) iv immédiatement après l’induction de l’anesthésie. Tous les sujets étaient anesthésiés au sévoflurane-protoxyde d’azote en oxygène. Après l’opération, pendant les premières 24 heures qui suivaient l’anesthésie, la fréquence des efforts pour vomir et les vomissements et l’incidence des effets indésirables étaient enregistrés par le personnel infirmier.
Résultats
Les groupes étaient identiques au regard de la démographie, de l’intervention chirurgicale, de l’anesthésie et de l’analgésie administrée pour la douleur postopératoire. La fréquence des symptômes était de 27% dans le groupe S, et de 7% dans le groupe D (P < 0,05). L’incidence des effets indésirables était comparable entre les deux groupes.
Conclusion
L’administration prophylactique de granisetron et de dexaméthasone était plus efficace que le granisetron seul pour prévenir les vomissements postopératoires chez des enfants soumis à une correction de strabisme, à une amygdalectomie et à une adénoïdectomie.
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References
Andrews PLR, Bhandari P, Davey PT, Bingham S, Marr HE, Blower PR. Are all 5-HT3 receptor antagonists the same? Eur J Cancer 1992; 28A: S2–6.
Bermudez J, Boyle EA, Miner WD, Sanger GJ. The anti-emetic potential of the 5-hydroxytryptamine3 receptor antagonist BRL 43694. Br J Cancer 1988; 58: 644–50.
Fujii Y, Tanaka H, Toyooka H. Granisetron reduces vomiting after strabismus surgery and tonsillectomy in children. Can J Anaesth 1996; 43: 35–8.
Smith DB, Newlands ES, Rustin GJS, et al. Comparison of ondansetron and ondansetron plus dexamethasone as antiemetic prophylaxis during cisplatin-containing chemotherapy. Lancet 1991; 338: 487–90.
Splinter WM, Rhine EJ, Gould HM, et al. Dexamethasone decreases vomiting by children after tonsillectomy. Can J Anaesth 1996; 43: A41.
Watcha MF, White PF. Postoperative nausea and vomiting. Its etiology, treatment, and prevention. Anesthesiology 1992; 77: 162–84.
Abramowitz MD, Oh TH, Epstein BS, Ruttimann UE, Friendly DS. The antiemetic effect of droperidol following outpatient strabismus surgery in children. Anesthesiology 1983; 97: 579–83.
Carithers JS, Gebhart DE, Williams JA. Postoperative risks of pediatric tonsilloadenoidectomy. Laryngoscope 1987; 97: 422–9.
Hitman RS, Wu LC, Catanzaro FA. Ondansetron decreases emesis after tonsillectomy in children. Anesth Analg 1994; 78: 478–81.
Rose JB, Martin TM, Corddry DH, Zagnoev M, Kettrick RG. Ondansetron reduces the incidence and severity of poststrabismus repair vomiting in children. Anesth Analg 1994; 79: 486–9.
Splinter WM, Rhine EJ, Roberts DW, et al. Ondansetron is a better prophylactic antiemetic than droperidol for tonsillectomy in children. Can J Anaesth 1995; 42: 848–51.
Fujii Y, Toyooka H, Tanaka H. Effective dose of granisetron for preventing postoperative emesis in children. Can J Anaesth 1996; 43: 660–4.
Fujii Y, Tanaka H, Toyooka H. Granisetron-dexamethasone combination reduces postoperative nausea and vomiting. Can J Anaesth 1995; 42: 387–90.
Carmichael J, Cantwell BMJ, Edwards CM, et al. A pharmacokinetic study of granisetron (BRL 43694A), a selective 5-HT3 receptor antagonist: correlation with anti-emetic response. Cancer Chemother Pharmacol 1989; 24: 45–9.
McKenzie R, Tantisira B, Karambelkar DJ, Riley TJ, Abdelhady H. Comparison of ondansetron with ondansetron plus dexamethasone in the prevention of postoperative nausea and vomiting. Anesth Analg 1994; 79: 961–4.
White PF, Watcha MF. Are new drugs cost-effective for patients undergoing ambulatory surgery? (Editorial) Anesthesiology 1993; 78: 2–5.
Lerman J. Are antiemetics cost-effective for children? (Editorial) Can J Anaesth 1995; 42: 263–6.
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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/s12630-012-9829-y.
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Fujii, Y., Tanaka, H. & Toyooka, H. RETRACTED ARTICLE: Granisetron and dexamethasone provide more improved prevention of postoperative emesis than granisetron alone in children. Can J Anaesth 43, 1229–1232 (1996). https://doi.org/10.1007/BF03013430
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DOI: https://doi.org/10.1007/BF03013430