Prevention of nausea and vomiting after day case gynaecological laparoscopy : a comparison of ondansetron, droperidol, metoclopramide and placebo

We have compared the efficacy of ondansetron, metoclopramide, droperidol and placebo in the prevention of postoperative nausea and vomiting in 118 day stay patients undergoing laparoscopic gynaecological procedures. All received a standardised general anaesthetic of fentanyl, propofol, nitrous oxide...

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Bibliographic Details
Published in:Anaesthesia 1995-05, Vol.50 (5), p.403-406
Main Authors: PAXTON, L. D, MCKAY, A. C, MIRAKHUR, R. K
Format: Article
Language:English
Subjects:
Adult
Ambulatory Surgical Procedures
Anesthesia, General
Biological and medical sciences
Digestive system
Double-Blind Method
Droperidol - therapeutic use
Female
Humans
Laparoscopy
Medical sciences
Metoclopramide - therapeutic use
Nausea - prevention & control
Ondansetron - therapeutic use
Pharmacology. Drug treatments
Postoperative Complications - prevention & control
Sterilization, Tubal
Vomiting - prevention & control
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Summary:We have compared the efficacy of ondansetron, metoclopramide, droperidol and placebo in the prevention of postoperative nausea and vomiting in 118 day stay patients undergoing laparoscopic gynaecological procedures. All received a standardised general anaesthetic of fentanyl, propofol, nitrous oxide in oxygen and isoflurane. Three to five min before induction of anaesthesia, patients were allocated to receive ondansetron 4 mg, metoclopramide 10 mg, droperidol 1 mg or placebo in a randomised, double-blind manner. Visual analogue scores for nausea, the incidence of emetic episodes, and analgesic and antiemetic consumption were recorded for 48 h postoperatively. The scores for nausea were significantly lower in the ondansetron group (p < 0.01) compared with the other three groups at 1, 2 and 4 h after operation; thereafter there was no difference. The incidence of emesis was lower (p = 0.063) and time to first oral fluids was shorter (p < 0.05) in the ondansetron group. Oral analgesic requirements were significantly greater in the ondansetron group over the 48 h study period. Two patients, one each in the placebo and metoclopramide groups, had to remain in hospital overnight because of persistent emetic symptoms.
ISSN:0003-2409
1365-2044
DOI:10.1111/j.1365-2044.1995.tb05993.x