Gender-Specific Differences in Low-Dose Haloperidol Response for Prevention of Postoperative Nausea and Vomiting: A Register-Based Cohort Study

Brettner, Florian; Janitza, Silke; Prüll, Kathrin; Weninger, E.; Mansmann, Ulrich; Küchenhoff, Helmut; Jovanovic, Alexander; Pollwein, Bernhard; Chappell, Daniel; Zwißler, Bernhard; Dossow, Vera von

doi:10.1371/journal.pone.0146746

Cited by 23 publications

(12 citation statements)

References 44 publications

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“…Brettner et al . 209 found gender-specific differences in the incidence of PONV (female > males) in the PACU after low-dose haloperidol (0.5 mg IV).…”

Section: Perioperative Antiemetic Drugs Used For the Treatment And/ormentioning

confidence: 81%

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Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review

et al. 2020

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Postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) remain common and distressing complications following surgery. The routine use of opioid analgesics for perioperative pain management is a major contributing factor to both PONV and PDNV after surgery. PONV and PDNV can delay discharge from the hospital or surgicenter, delay the return to normal activities of daily living after discharge home, and increase medical costs. The high incidence of PONV and PDNV has persisted despite the introduction of many new antiemetic drugs (and more aggressive use of antiemetic prophylaxis) over the last two decades as a result of growth in minimally invasive ambulatory surgery and the increased emphasis on earlier mobilization and discharge after both minor and major surgical procedures (e.g. enhanced recovery protocols). Pharmacologic management of PONV should be tailored to the patient’s risk level using the validated PONV and PDNV risk-scoring systems to encourage cost-effective practices and minimize the potential for adverse side effects due to drug interactions in the perioperative period. A combination of prophylactic antiemetic drugs with different mechanisms of action should be administered to patients with moderate to high risk of developing PONV. In addition to utilizing prophylactic antiemetic drugs, the management of perioperative pain using opioid-sparing multimodal analgesic techniques is critically important for achieving an enhanced recovery after surgery. In conclusion, the utilization of strategies to reduce the baseline risk of PONV (e.g. adequate hydration and the use of nonpharmacologic antiemetic and opioid-sparing analgesic techniques) and implementing multimodal antiemetic and analgesic regimens will reduce the likelihood of patients developing PONV and PDNV after surgery.

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“…Brettner et al . 209 found gender-specific differences in the incidence of PONV (female > males) in the PACU after low-dose haloperidol (0.5 mg IV).…”

Section: Perioperative Antiemetic Drugs Used For the Treatment And/ormentioning

confidence: 81%

“…The incidence of QTc prolongation with haloperidol is statistically equivalent to the 5-HT 3 antagonists. Brettner et al 209 found gender-specific differences in the incidence of PONV (female > males) in the PACU after low-dose haloperidol (0.5 mg IV).…”

Section: Tricyclic Antidepressantsmentioning

confidence: 99%

Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review

et al. 2020

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“…However, it should be noted that the effect of ondansetron is more than other drugs in most studies. Considering the negative effect of endonestrone on hemodynamic therapy, it is advised to use this drug [ 17 ] [ 19 ] [ 20 ]. The prophylactic use of this drug is recommended in women’s surgery, especially abdominal hysterectomy.…”

Section: Discussionmentioning

confidence: 99%

Investigation of Ondansetron, Haloperidol, and Dexmedetomidine Efficacy for Prevention of Postoperative Nausea and Vomiting In Patients with Abdominal Hysterectomy

Kamali¹,

Ahmadi²,

Shokrpour³

et al. 2018

Open Access Maced J Med Sci

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AIM:This study was aimed to compare the effects of ondansetron, haloperidol, and dexmedetomidine for reducing postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy.METHODS:This randomised clinical trial study was performed on p.patients who were candidates for abdominal hysterectomy referring to Taleghani hospital in Arak. In this study, 114 patients with abdominal hysterectomy were randomly assigned to three groups (ondansetron, haloperidol, and dexmedetomidine) using the cubull randomisation method.RESULTS:The results revealed a significant difference between the three groups of ondansetron, haloperidol and dexmedetomidine in terms of scorpion vomiting in recovery, 2 and 4 hours after surgery, and vomiting score was significantly lower in the ondansetron group compared with the other two groups (P = 0.04; P = 0.02; P = 0.001). There was a significant difference between the three groups of e ondansetron, haloperidol and dexmedetomidine regarding the mean dose of metoclopramide in mg for 24 hours after surgery. Therefore, the dosage of dexmedetomidine in the ondansetron group was less than the other two groups (P = 0.001).CONCLUSION:these three drugs are effective in reducing PONV in patients undergoing a hysterectomy. However, the effect of ondansetron was found to be more than the other two drugs in reducing PONV.

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“…10 )HPDOHV DOVR H[SHULHQFH UHGXFHG EHQH¿FLDO effects from pharmacological prophylaxis. 11 The exact mechanisms responsible for the increased incidence of PONV in females are unknown. Studies have suggested that PONV ULVN LQ IHPDOHV LV LQÀXHQFHG E\ PHQVWUXDO phase, with the highest risk occurring during the follicular phase and lowest risk during the luteal phase.…”

Section: Introductionmentioning

confidence: 99%

PONV Prophylaxis Failure Disproportionately Affects Female Patients, Despite Intraoperative Computerized Decision Support Guidance

2020

GMERJ

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Objectives: To compare postoperative nausea and vomiting (PONV) prophylaxis treatment and outcomes based on patients' sex, using a retrospective cohort. The setting was the operating room and postanesthesia care unit of a tertiary care university medical center. Patients: A total of 678 adult male and female patients with American Society of Anesthesiologist (ASA) scores of 1-4 underwent surgery with general anesthesia. All patients received preoperative PONV risk assessment. PONV prophylaxis was administered at the discretion of the anesthesia care team members with guidance from a computerized decision support system. Measurements: Adequacy of prophylaxis was retrospectively determined based on individual patient risk factors and the observed treatment received, compared with guideline-based prophylaxis recommendations. Patient outcome was measured by diagnosis of PONV in recovery. Results: Comparing patients who received fewer than the guideline-recommended number of prophylactic antiemetics by sex, 94.6% were female and 5.4% were males (p < 0.001). Patients who received fewer than guideline-recommended number of antiemetics had significantly higher rates of nausea or vomiting in the post-anesthesia care unit (30.4% vs 17.5%, p < 0.001). Conclusion: This retrospective cohort study shows that female patients receiving general anesthesia are disproportionately affected by failure to adhere to PONV prevention guidelines.

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Gender-Specific Differences in Low-Dose Haloperidol Response for Prevention of Postoperative Nausea and Vomiting: A Register-Based Cohort Study

Cited by 23 publications

References 44 publications

Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review

Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review

Investigation of Ondansetron, Haloperidol, and Dexmedetomidine Efficacy for Prevention of Postoperative Nausea and Vomiting In Patients with Abdominal Hysterectomy

PONV Prophylaxis Failure Disproportionately Affects Female Patients, Despite Intraoperative Computerized Decision Support Guidance

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