Granisetron, droperidol, and metoclopramide for preventing postoperative nausea and vomiting after thyroidectomy.

Abstract

Patients undergoing thyroidectomy may be especially at risk of experiencing postoperative nausea and vomiting (PONV). This study was undertaken to compare the efficacy and safety of granisetron, droperidol, and metoclopramide for preventing PONV after thyroidectomy. Prospective randomized, double-blind study. One hundred twenty female patients received granisetron 40 microg/kg, droperidol 20 microg/kg, or metoclopramide 0.2 mg/kg (n = 40, each) intravenously (IV) immediately before the induction of anesthesia. A standardized general anesthetic technique was employed throughout the procedure. The incidence of a complete response, that is, no PONV and no need for another rescue antiemetic during the first 3 hours (0 to 3 hours) after anesthesia was 90% with granisetron, 55% with droperidol, and 50% with metoclopramide, respectively; the corresponding incidence during the next 21 hours (3 to 24 hours) after anesthesia was 85%, 50%, and 45% (P<.05; overall Fisher's Exact probability test). No clinically important adverse events were observed in any of the groups. Prophylactic therapy with granisetron is superior to droperidol or metoclopramide for preventing PONV after thyroidectomy.