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Prevention of Vomiting After Tonsillectomy in Children: Granisetron Versus Ramosetron
Author(s) -
Fujii Yoshitaka,
Saitoh Yuhji,
Kobayashi Noriaki
Publication year - 2001
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200102000-00013
Subject(s) - granisetron , medicine , antiemetic , anesthesia , tonsillectomy , vomiting , postoperative nausea and vomiting
Objective/Hypothesis Granisetron, a selective 5‐hydroxytryptamine type 3 receptor antagonist, is effective for the prevention of vomiting after tonsillectomy in children. Ramosetron (Nasea; Yamanouchi; Tokyo, Japan), another new antagonist of 5‐hydroxytryptamione type 3 receptor, has more potent and longer‐acting properties than granisetron (Kytril; Smith Kline Beecham, London, UK) against cisplatin‐induced emesis. This study was undertaken to compare the efficacy and safety of granisetron and ramosetron for the prevention of vomiting after pediatric tonsillectomy. Study Design Prospective, randomized, double‐blinded study. Methods Ninety pediatric patients, aged 4 to 10 years, received intravenously granisetron 40 μg/kg or ramosetron 6 μg/kg (n = 45 each) at the end of surgery. The same standard general anesthetic technique and postoperative analgesia were used throughout. Emetic episodes and safety assessment were performed during the first 24‐hour period and the next 24‐hour period after anesthesia. Results The rates of patients being emesis‐free during the period from 0 to 24 hours after anesthesia were 89% with granisetron and 93% with ramosetron, respectively ( P = .357); the corresponding rates during the period from 24 to 48 hours after anesthesia were 71% and 93%, respectively ( P = .006). No clinically serious adverse events attributable to the study drugs were observed in any of the groups. Conclusion Ramosetron is a better antiemetic than granisetron for the long‐term prevention of postoperative vomiting in children undergoing general anesthesia for tonsillectomy.