Randomized clinical trial of granisetron, droperidol and metoclopramide for the treatment of nausea and vomiting after laparoscopic cholecystectomy.

Abstract

Patients undergoing laparoscopic cholecystectomy (LC) may be especially at risk of experiencing postoperative nausea and vomiting (PONV). This study was undertaken to evaluate the efficacy of granisetron, droperidol and metoclopramide for the treatment of PONV after LC. After experiencing PONV during the first 3 h after recovery from anaesthesia, 120 patients (78 women) received, in a randomized double-blind manner, granisetron 40 microg/kg, droperidol 20 microg/kg or metoclopramide 0.2 mg/kg (n = 40 per group) intravenously. Patients were then observed for 24 h after administration of the study drug. Complete control of established PONV, defined as no emetic symptoms and no need for another rescue antiemetic medication, was achieved in 88 per cent of patients with granisetron, 60 per cent with droperidol and 55 per cent with metoclopramide (P < 0.05). No clinically adverse events were observed in any of the groups. A high dose of granisetron (40 microg/kg) was more effective than droperidol 20 microg/kg or metoclopramide 0.2 mg/kg for the treatment of established PONV after LC.