Antiemetic efficacy of prophylactic dimenhydrinate (Dramamine) vs ondansetron (Zofran)

Kothari, Shanu N.; Boyd, William C.; Böttcher, Michael; Lambert, Pamela J.

doi:10.1007/s004640080055

Cited by 39 publications

(5 citation statements)

References 15 publications

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“…The discrepancy probably due to our use of these drugs in combination with dexamethasone while Kothari gave them alone. 33 Contrary to our results Piwko C & associates showed that for vomiting the Ondansetron group had an efficacy of 45.3% vs the Dimenhydrinate group's 38.2% while ours was 75% for Ondansetron vs a 91% in Dimenhydrinate group. Piwko evaluated prevention of vomiting only in children whereas our study population were adults.…”

Section: Discussioncontrasting

confidence: 99%

Role of Prophylactic Dimenhydrinate Versus Ondansetron as an Adjunct to Dexamethasone on Post-Operative Nausea and Vomiting in Laparoscopic Abdominal Procedures

Niazi¹,

Bukhari

Ali

et al. 2020

Proceedings

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Introduction: Post-operative nausea and vomiting (PONV) is a common complication in patients undergoing surgery. Anti-emetic prophylaxis is recommended for all high risk patients. Combination therapy is considered superior to single dose prophylaxis however its efficacy in varied laparoscopic abdominal surgical situations has not been investigated. Aims & Objectives: To compare the post-operative nausea and vomiting with Dimenhydrinate plus Dexamethasone versus Ondansetron plus Dexamethasone in patients following laparoscopic abdominal procedures. Place and duration of study: Operation Theatre, Shaikh Zayed Hospital Lahore, for one year (1st April 2015 – 31st March 2016). Material & Methods: 464 patients were placed in two groups of 232 each. Group A received prophylaxis with Dexamethasone 8 mg I/V + Dimenhydrinate 50mg I/V and Group B received prophylaxis with Dexamethasone 8 mg I/V + Ondansetron 4 mg I/V. Efficacy was judged with absence of nausea and vomiting in first 24 hours after surgery. Data was analyzed in SPSS version 27. Results: The frequency of nausea was 6% with Dimenhydrinate while was 9% with ondansetron. Similarly, vomiting was 18% vs. 24% respectively. The efficacy of Dimenhydrinate was 88% while and Ondansetron achieved efficacy in 65% cases, which was statistically significant (p<0.05). Conclusion: The combination Dexamethasone & Dimenhydrinate was more efficacious in preventing PONV than the combination Dexamethasone & Ondansetron

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Section: Discussioncontrasting

confidence: 99%

Role of Prophylactic Dimenhydrinate Versus Ondansetron as an Adjunct to Dexamethasone on Post-Operative Nausea and Vomiting in Laparoscopic Abdominal Procedures

Niazi¹,

Bukhari

Ali

et al. 2020

Proceedings

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“…Several antiemetics of different pharmacological classes are available to prevent PONV in patients scheduled to receive elective surgery. These include anticholinergics [ 8 , 9 ], antihistamines [ 10 ], phenothiazines [ 11 ], and butyrophenones [ 12 ]. Currently, selective 5-hydroxytryptamine type 3 (5-HT 3 ) receptor antagonists (ondansetron, granisetron, tropisetron, and dolasetron) are frequently used in the prevention of PONV, due to their efficacy and lesser adverse effects than other antiemetics [ 13 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

Effective Dose of Ramosetron for Prophylaxis of Postoperative Nausea and Vomiting in High-Risk Patients

Lee

Jeong

Kim

et al. 2015

BioMed Research International

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Background. Postoperative nausea and vomiting (PONV) are common adverse events with an incidence of up to 80% in high-risk patients. Ramosetron, a selective 5-HT3 receptor antagonist, is widely used to prevent PONV. The purpose of this study was to evaluate the effective dose of ramosetron for the prevention of PONV in high-risk patients. Methods. Fifty-one patients were randomly allocated to 3 groups and were administered ramosetron 0.3 mg (group A), 0.45 mg (group B), or 0.6 mg (group C), at the end of their surgery. The episodes of PONV were assessed 1, 6, 24, and 48 hours after the injection and all the adverse events were observed. Results. The complete response rate in the postoperative period 6–24 hours after the anesthesia was higher in group C than in group A: 93% versus 44%. Group C's experience score of Rhodes index was lower than group A's: 0.81 ± 2.56 versus 3.94 ± 5.25. No adverse drug reaction could be observed in all groups. Conclusions. The effective dose of ramosetron to be injected for the near-complete prophylaxis of PONV 6 to 24 hours after surgery in high-risk patients is a 0.6 mg bolus injection at the end of the surgery.

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“… 14 Dimenhydrinate, a theophylline derivative traditionally used for motion sickness, is also a low-cost antiemetic that has been shown to be equally effective as ondansetron at preventing PONV. 15 The use of additional medications to provide ‘supraoptimal’ prophylaxis, when compared with regimens similar to that of the three-drug combination used at our institution, has been shown to decrease PONV rates in an observational study of bariatric surgery patients. 16 Variations of supraoptimal prophylaxis are practised presently at our institution and affiliated hospitals for selected patients.…”

Section: Methods and Analysismentioning

confidence: 92%

“…Aprepitant, a neurokinin-1 inhibitor commonly used for chemotherapy-induced nausea, has shown promising results in improving rates of PONV when added to a multimodal prophylactic regimen 14. Dimenhydrinate, a theophylline derivative traditionally used for motion sickness, is also a low-cost antiemetic that has been shown to be equally effective as ondansetron at preventing PONV 15. The use of additional medications to provide ‘supraoptimal’ prophylaxis, when compared with regimens similar to that of the three-drug combination used at our institution, has been shown to decrease PONV rates in an observational study of bariatric surgery patients 16.…”

Section: Methods and Analysismentioning

confidence: 99%

REMAP Periop: a randomised, embedded, multifactorial adaptive platform trial protocol for perioperative medicine to determine the optimal enhanced recovery pathway components in complex abdominal surgery patients within a US healthcare system

Holder-Murray,

Esper,

Althans

et al. 2023

BMJ Open

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IntroductionImplementation of enhanced recovery pathways (ERPs) has resulted in improved patient-centred outcomes and decreased costs. However, there is a lack of high-level evidence for many ERP elements. We have designed a randomised, embedded, multifactorial, adaptive platform perioperative medicine (REMAP Periop) trial to evaluate the effectiveness of several perioperative therapies for patients undergoing complex abdominal surgery as part of an ERP. This trial will begin with two domains: postoperative nausea/vomiting (PONV) prophylaxis and regional/neuraxial analgesia. Patients enrolled in the trial will be randomised to arms within both domains, with the possibility of adding additional domains in the future.Methods and analysisIn the PONV domain, patients are randomised to optimal versus supraoptimal prophylactic regimens. In the regional/neuraxial domain, patients are randomised to one of five different single-injection techniques/combination of techniques. The primary study endpoint is hospital-free days at 30 days, with additional domain-specific secondary endpoints of PONV incidence and postoperative opioid consumption. The efficacy of an intervention arm within a given domain will be evaluated at regular interim analyses using Bayesian statistical analysis. At the beginning of the trial, participants will have an equal probability of being allocated to any given intervention within a domain (ie, simple 1:1 randomisation), with response adaptive randomisation guiding changes to allocation ratios after interim analyses when applicable based on prespecified statistical triggers. Triggers met at interim analysis may also result in intervention dropping.Ethics and disseminationThe core protocol and domain-specific appendices were approved by the University of Pittsburgh Institutional Review Board. A waiver of informed consent was obtained for this trial. Trial results will be announced to the public and healthcare providers once prespecified statistical triggers of interest are reached as described in the core protocol, and the most favourable interventions will then be implemented as a standardised institutional protocol.Trial registration numberNCT04606264.

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Antiemetic efficacy of prophylactic dimenhydrinate (Dramamine) vs ondansetron (Zofran)

Cited by 39 publications

References 15 publications

Role of Prophylactic Dimenhydrinate Versus Ondansetron as an Adjunct to Dexamethasone on Post-Operative Nausea and Vomiting in Laparoscopic Abdominal Procedures

Role of Prophylactic Dimenhydrinate Versus Ondansetron as an Adjunct to Dexamethasone on Post-Operative Nausea and Vomiting in Laparoscopic Abdominal Procedures

Effective Dose of Ramosetron for Prophylaxis of Postoperative Nausea and Vomiting in High-Risk Patients

REMAP Periop: a randomised, embedded, multifactorial adaptive platform trial protocol for perioperative medicine to determine the optimal enhanced recovery pathway components in complex abdominal surgery patients within a US healthcare system

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