Prophylactic anti-emetic therapy with granisetron, droperidol and metoclopramide in female patients undergoing middle ear surgery

Abstract

The efficacy of granisetron, droperidol and metoclopramide for the prevention of postoperative nausea and vomiting in female patients undergoing middle ear surgery was compared. In a randomised, double-blind study, 180 patients received granisetron 40 μg.kg-1, droperidol 20 μg.kg-1 or metoclopramide 0.2 mg.kg-1 given intravenously immediately before induction of anaesthesia (n = 60 for each). A standardised general anaesthetic technique was employed throughout. A complete response, defined as no postoperative nausea and vomiting and no need for another rescue anti-emetic, during the first 3 h after anaesthesia was achieved in 83%, 58% and 55% of patients who had received granisetron, droperidol and metoclopramide, respectively. The corresponding incidence during the next 21 h after anaesthesia was 85%, 54% and 47% (p < 0.05). No clinically important adverse effects were observed in any of the groups. We conclude that prophylactic therapy with granisetron is superior to droperidol or metoclopramide in the prevention of postoperative nausea and vomiting after middle ear surgery.