Comparison of ondansetron and metoclopramide for the prevention of post-operative nausea and vomiting after major gynaecological surgery

Abstract

P. P. Chen et al (1996) European Journal of Anaesthesiology, 13, 485-491 Comparison of ondansetron and metoclopramide for the prevention of post-operative nausea and vomiting after major gynaecological surgery Summary ondansetron group (n=25) and eight patients (33%) in the metoclopramide group (n=24) vomited, The efficacy of ondansetron 4 mg was compared with whereas at 4-12 h, this increased to 11 patients (44%) metoclopramide 10 mg for the prevention of postand nine patients (37.5%) respectively. The incidence operative nausea and vomiting in patients after major was 52 and 37.5% respectively in the subsequent gynaecological abdominal surgery. Anaesthesia was 12-24 h. The highest incidence of nausea was in the standardized using thiopentone, atracurium and methfirst 4 h after surgery, being 56 and 37.5% in the adone for induction followed by isoflurane in nitrous ondansetron and the metoclopramide groups reoxide-oxygen mixture. Fifty patients were randomized spectively. This decreased to less than 25% in both groups in the 12-24 h period. Ondansetron 4 mg and in a double-blind fashion to either receive intravenous metoclopramide 10 mg had similar but short lasting (i.v.) ondansetron 4 mg or metoclopramide 10 mg durefficacy for the prevention of vomiting in patients ing closure of the pelvic peritoneum. The incidence who received continued opioid analgesia after major and frequency of vomiting, and the incidence of severe gynaecological surgery. nausea was recorded for 24 h after surgery. One patient was excluded because of respiratory depression. In the first 4 h after surgery, five patients (20%) in the macology, ondansetron, metoclopramide.

5-HT3 receptor antagonistsvs traditional agents for the prophylaxis of postoperative nausea and vomiting

“…56 Thus, for the PONV endpoint, the seven trials that fell outside this region were thought to be statistically heterogeneous. 14,23,25,28,33,36,42 On closer inspection of these trials, there was no factor determined to be common among them which would explain their dissimilar results from the aggregate. For the vomiting endpoint, five trials fell outside the region of homogeneity.…”

Ondansetrona oral na prevenção de náuseas e vômitos pós-operatórios

“…A ondansetrona intravenosa, administrada no pré-operatório ou no intra-operatório tem-se mostrado eficaz na prevenção de NVPO tanto em adultos como em crianças 8,13,56,85,87,[89][90][91][92]110,111 . São, todavia, relativamente poucos os estudos que tratam da eficá-cia da ondansetrona oral na prevenção de NVPO 6,7,[112][113][114][115][116][117] .…”

Management of Postoperative Nausea and Vomiting in Women Undergoing Major Gynecological Surgery: A Review and Update

“…Chen et al demonstrated that metoclopramide 10 mg administered i.v. immediately before the end of surgery was effective in preventing PONV [12]. Similarly, Piper et al found the efficacy of metoclopramide 20 mg administered i.v.…”

“…Phenothiazines (e.g., perphenazine), butyrophenones (e.g., droepridol), benzamides (e.g., metoclopramide) and antihistamines (e.g., cyclizine) are used as traditional antiemetics for preventing PONV after major gynecological surgery in women [6][7][8][9][10][11][12] (Table 1). Phenothiazines exert an antiemetic effect by blocking dopamine receptors in the chemoreceptor trigger zone (CTZ) and other areas of the brain (area postrema) [70].…”

“…Metoclopramide is widely used as an antiemetic in clinical practice [1][2][3], and the efficacy of this agent for preventing PONV in women undergoing major gynecological surgery [6,12,13]. Chen et al demonstrated that metoclopramide 10 mg administered i.v.…”