Low-dose granisetron for postoperative nausea and vomiting prophylaxis

OBJECTIVE: To evaluate the use of low-dose granisetron in postoperative nausea and vomiting prophylaxis. DATA SOURCES: Clinical trials available through PubMed and OVID (1966-July 2003), as well as information supplied by the drug manufacturer, were accessed. DATA SYNTHESIS: Safety concerns associated with droperidol and limited availability of other agents have created a need to restructure prophylaxis guidelines for postoperative nausea and vomiting. It has recently been proposed that granisetron may be effective at a dose that is one-tenth of the Food and Drug Administration-approved dose. Conflicting evidence for this regimen is evaluated. CONCLUSIONS: Based on the scarcity of supporting data, this regimen is not recommended for prophylaxis in patients at risk for postoperative nausea and vomiting.