Abstract
Purpose
This study was to identify the minimum effective dose of granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, to prevent postoperative vomiting in children who have undergone strabismus repair, tonsillectomy or tonsillectomy with adenoidectomy.
Methods
In a randomized, double-blind fashion, 80 healthy children aged 4–10 yr were assigned to receive either placebo (saline) or granisetron in a dose of 20, 40 or 80 μg· kg−1 iv immediately following the induction of anaesthesia. All subjects received a standardized anaesthetic, which consisted of sevoflurane in nitrous oxide and oxygen. Rescue antiemetics were administered if two or more episodes of vomiting occurred. Postoperative pain was treated with acetaminophene pr or pentazocine iv. During the first 24 hr after anaesthesia, the frequencies of retching and vomiting were recorded in a standardized fashion by nursing staff while subjects were in a hospital.
Results
There were no differences among four treatment groups with regard to subject characteristics, surgical procedures, anaesthetic and postoperative management or adverse effects. The frequencies of these symptoms were as follows: 65%, 60%, 20% and 15% after administration of placebo, granisetron 20, 40 or 80 μg· kg−1. Three children who had received either placebo or granisetron 20 μg · kg−1 required another rescue antiemetic drug, whereas none who had received granisetron 40 or 80 μg · kg−1 needed rescue drugs.
Conclusion
Granisetron 40 μg · kg−1 is an effective antiemetic for preventing retching and vomiting following strabismus repair and tonsillectomy in children. Increasing the dose to 80 μg ·kg −1provided no demonstrable benefit in reducing postoperative emesis.
Résumé
Objectif
Cette étude visait à identifier la dose efficace minimale de granisetron, un antagoniste sélectif du récepteur de type 3 de la 5-hydroxytryptamine, nécessaire pour prévenir les vomissements postopératoires chez des enfants soumis à une correction de strabisme, ou à amygdalectomie avec ou sans adénoïdectomie.
Méthodes
Au cours d’une étude aléatoire et en double aveugle, 80 patients âgés de quatre à dix ans ont été répartis pour recevoir soit une placebo, soit du granistron à la dose de 20, 40 ou 80 μg · kg−1 iv immédiatement après l’induction de l’anesthésie. Tous les sujets ont reçu la même anesthésie soit du sévoflurane en oxygène et protoxyde d’azote. Un antiémétique de sauvetage était administré après deux épisodes de vomissements ou plus. La douleur postopératire était traitée avec de l’acétaminophène rectal ou de la pentazocine iv. Pendant les 24 premières heures qui suivaient l’anesthésie, la fréquence des efforts pour vomir et les vomissements ont été enregistrés de façon standardisée par le personnel infirmier pendant le séjour des sujets à l’hôspital.
Résultats
Les caractéristiques, les interventions chirurgicales, la gestion anesthésique et postopératoire ou les réactions défavorables ont été les mêmes pour les deux groupes. La fréquence des vomissements a été de 65%, 60%, 20% et 15% respectivement après l’administration du placebo, du granisetron 20, 40 ou 80 μg · kg−1. Trois enfants qui avaient reçu le placebo ou le granisetron 20 μg · kg−1 ont eu besoin d’un antiémétique de sauvetage alors qu’aucun de ceux qui avaient reçu le granisetron 40 ou 80 μg · kg−1 n’a eu besoin d’un tel médicament.
Conclusion
Le granisetron 40 μg · kg−1 est un antiémétique efficace qui prévient les efforts pour vomir et les vomissements consécutifs à une correction de strabisme ou une amygdalectomie chez l’enfant. L’augmentation de la dose à 80 μg · kg−1 ne procure pas d’avantages supplémentaires.
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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/s12630-012-9831-4.
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Fujii, Y., Toyooka, H. & Tanaka, H. RETRACTED ARTICLE: Effective dose of granisetron for preventing postoperative emesis in children. Can J Anesth 43, 660–664 (1996). https://doi.org/10.1007/BF03017947
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DOI: https://doi.org/10.1007/BF03017947