Effect of Adding Midazolam to Dual Prophylaxis for Preventing Postoperative Nausea and Vomiting

Lee, Jiyoung; Yi, In Kyong; Han, Jung Youn; Na, Eun Duc; Park, Chunghyun; Kim, Jong Yeop

doi:10.3390/jcm10214857

Cited by 2 publications

(1 citation statement)

References 39 publications

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“…Previous studies revealed that the incidence of PONV in these patients is as high as 40-80%. 19,20 However, our study revealed a PONV incidence of as low as 9.8%, which signi cantly improves postoperative satisfaction and promotes postoperative rehabilitation of patients.…”

Section: Dicussionmentioning

confidence: 58%

Promethazine for nausea and vomiting prevention after gynaecological laparoscopic surgery：a randomized controlled trial

Ruijuan,

Ruirui,

Jiqiang

et al. 2023

Preprint

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Background: Postoperative nausea and vomiting (PONV) are the postoperative problem that patients undergoing surgery do not want to experience. The incidence of PONV in female patients undergoing laparoscopic surgery is about 40%, and the risk of PONV is as high as 80% in those patients who have not received preventive treatment. At present still did not have the consummation effective solution. Methods: This prospective, single-centre, two-armed, randomised, double-blind, pilot study was conducted in Gansu Provincial Hospital from June 2021 to March 2022 and included 100 subjects, aged 18–65 years, who underwent nonemergent gynaecological laparoscopic surgery. Before anaesthesia induction, 6.25-mg promethazine or 1-mL saline was intravenously administered. All subjects received postoperative patient-controlled intravenous analgesia and continuous metoclopramide infusion at 50 mg. The primary outcome was the incidence and severity of postoperative nausea and vomiting at 6 h, 24 h, 48 h, and 72 h postoperatively. Results:The incidence and severity of nausea during the early period (the first 6 h postoperatively) was significantly different between groups (P = 0.043, P = 0.048). A statistically significant difference was found in the incidence and severity within 24 h postoperatively (P = 0.026, P = 0.003). Vomiting incidence and severity were lower than in the control group at the 6 h postoperatively but without statistical difference between the two groups (P = 0.166, P = 0.180). Vomiting incidence and severity were statistically different during the 24 h postoperatively (P = 0.011, P = 0.004). A significant statistical difference was found in the satisfaction between the two groups during the postoperative observation period (P = 0.002). Conclusion:Preoperative prophylactic promethazine significantly reduced the incidence and severity of postoperative nausea and vomiting within 24 h postoperatively, with few adverse effects and no serious adverse reactions. And the satisfaction of patients is improved. Clinical Trials Registration Number:（18/12/2021）ChiCTR2100054495

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Section: Dicussionmentioning

confidence: 58%

Promethazine for nausea and vomiting prevention after gynaecological laparoscopic surgery：a randomized controlled trial

Ruijuan,

Ruirui,

Jiqiang

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

Effects of adding intravenous midazolam to a dual postoperative nausea and vomiting regimen in patients undergoing breast surgery: A pragmatic randomized controlled trial

Mingvoramethakul,

Kampitak,

Anusorntanawat

et al. 2024

Saudi Journal of Anaesthesia

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Background: For high-risk patients, adding a third antiemetic drug to dual postoperative nausea and vomiting (PONV) prophylaxis is controversial. Given the established antiemetic properties of midazolam, this study compared the combination of low-dose dexamethasone-ondansetron and midazolam with high-dose dexamethasone-ondansetron. Methods: A total of 300 female patients scheduled for breast surgery were recruited and randomly assigned to two groups. The DO group received dexamethasone 8 mg and ondansetron 4 mg, whereas the DOM group received dexamethasone 4 mg, ondansetron 4 mg, and midazolam 0.04 mg/kg. The primary outcome was the incidence of PONV within 24 h. Secondary outcomes were PONV severity, antiemetic requirement, blood glucose levels, satisfaction and sedation scores, time to eye opening and extubation, pain outcome, and sore throat. Results: Primary outcome analysis included 298 patients. Incidence of PONV within the first 24 h after surgery occurred in 52 of 150 (35%) patients in the DO group and 33 of 148 (22%) patients in the DOM group (adjusted risk ratio, 0.63; 95% confidence interval, 0.45–0.88; P = 0.007). The antiemetic requirement was significantly greater in the DO group compared with the DOM group (P = 0.034). However, a significantly higher sedation level and longer time for eye-opening and extubation were observed in the DOM group (P < 0.05). Conclusion: Compared to high-dose dexamethasone and ondansetron alone, midazolam combined with low-dose dexamethasone and ondansetron decreased the incidence of PONV in patients undergoing breast surgery; however, it increased the sedation level in the early postoperative period.

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Effect of Adding Midazolam to Dual Prophylaxis for Preventing Postoperative Nausea and Vomiting

Cited by 2 publications

References 39 publications

Promethazine for nausea and vomiting prevention after gynaecological laparoscopic surgery：a randomized controlled trial

Promethazine for nausea and vomiting prevention after gynaecological laparoscopic surgery：a randomized controlled trial

Effects of adding intravenous midazolam to a dual postoperative nausea and vomiting regimen in patients undergoing breast surgery: A pragmatic randomized controlled trial

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