Nitrous oxide does not increase nausea and vomiting following gynaecological laparoscopy

Hovorka, J.; Korttila, K.; Erkola, Olli

doi:10.1007/bf03011437

Cited by 95 publications

(23 citation statements)

References 7 publications

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“…In spite of these precautions, nearly all patients not receiving a prophylactic antiemetic experienced nausea and about 50% actually vomited. This is in keeping with the other reports of PONV in patients undergoing gynaecological surgery, particularly for laparoscopic procedures [4,7,15,23,24].…”

Section: Discussionsupporting

confidence: 91%

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Prevention of nausea and vomiting after day case gynaecological laparoscopy

Paxton¹,

McKay²,

Mirakhur³

1995

Anaesthesia

112

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SummaryWe have compared the efficacy of ondansetron, metoclopramide, droperidol and placebo Key wordsAnaesthesia; gynaecological, laparoscopy .Vomiting; antiemetics, ondansetron, droperidol, metoclopramide. Nausea and vomiting are frequent postoperative events, the incidence ranging from 30 to 83% and is an important cause of unscheduled hospital stay in day case surgery [l-51. The aetiology of postoperative nausea and vomiting (PONV) is multifactorial and includes age, gender, the day of the menstrual cycle, type of surgery, and the anaesthetic technique [6-81. Ondansetron, a 5-HT, receptor antagonist, is a relatively new antiemetic drug which has been shown to be effective in reducing chemo-and radiotherapy induced sickness [9, lo]. More recent studies have shown that it is effective in the prevention and treatment of PONV when compared to placebo [I 1-13]. However, there are no direct comparative studies with other commonly used and well established antiemetic drugs, such as metaclopramide and droperidol in day stay laparoscopic surgery. The present investigation was carried out to make a direct comparison between ondansetron and these antiemetics in a placebo-controlled study. Patients and methodsFollowing approval by the local ethics committee and written informed consent, 140 patients undergoing diagnostic laparoscopy or laparoscopic sterilisation were included in the study. Patients were admitted to the Day Procedure Unit following an overnight fast of 8 to 10 h. At the pre-anaesthetic interview the patients were familiarised with a postoperative questionnaire and a scale (0-lOcm) for recording visual analogue scores (VAS). No premedication was administered. Patients were randomly allocated to receive one of the following by intravenous injection: ondansetron 4 mg, droperidol 1 mg, metoclopramide 10 mg, or placebo (0.90/, normal saline). A double-blind design was used and the drugs were administered 3 to 5min before induction of anaesthesia.Anaesthesia was induced with propofol 2-3 mg.kg-' and fentanyl 1-1.5 pg.kg-'. Atracurium 0.2-0.3 mg/kg-'

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Section: Discussionsupporting

confidence: 91%

“…Visual analogue scores (VAS) for nausea were recorded in the hospital or at home at 1, 2, 4, 6, 12, 24 and 48 h following surgery, as were the times and frequency of any emetic episodes. An episode of nausea was scored if the VAS was greater than zero on the scale.…”

Section: Methodsmentioning

confidence: 99%

Prevention of nausea and vomiting after day case gynaecological laparoscopy

Paxton¹,

McKay²,

Mirakhur³

1995

Anaesthesia

112

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“…1 One of the highest incidences of postoperative nausea and vomiting (PONV) occurs after gynecological laparoscopy, ranging from approximately 40 -77%. 2 Postoperative nausea and vomiting predisposes patients to increased pain, bleeding, dehydration, electrolyte imbalance and retardation in wound healing, as well as being the principle source of prolonged discharge and unplanned postoperative hospital admission. 3 It is not surprising that PONV following outpatient gynecological surgery has been considered more debilitating than the surgery itself by patients 4 and needs to be addressed further as emphasized by Stockall with research comparing new vs old anti-emetic therapies.…”

mentioning

confidence: 99%

Additive anti-emetic efficacy of prophylactic ondansetron with droperidol in out-patient gynecological laparoscopy

Belo

Koutsoukos

2000

Can J Anesth/J Can Anesth

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Purpose: To determine the efficacy of ondansetron and droperidol, alone and in combination, administered for prophylaxis of postoperative nausea and vomiting (PONV) in women undergoing general anesthesia for outpatient gynecological laparoscopy.Methods: Following Institutional Ethics Board approval and patient consent, 160 female out-patients scheduled for laparoscopy were randomly allotted in a double-blind fashion to receive: i) saline (placebo), ii) 4 mg ondansetron, iii) 1.25 mg droperidol, or iv) 4 mg ondansetron and 1.25 mg droperidol combination intravenously on induction. Following a standardized general anesthesia, patients were interviewed and assessed for PONV at various times.Results: During the first 24 hr after surgery, the incidence of PONV in the placebo group was 71%. This was reduced to 61% with droperidol alone (P = 0.334), to 46% with ondansetron alone (P = 0.027), and to 23% with the combination group (P < 0.001). A statistically significant difference was observed between combination and droperidol (P < 0.001) and between combination and ondansetron (P = 0.036). There were fewer requests for rescue medication from the combination group (7.7%) than from the ondansetron and placebo groups. Conclusion:The results of this study suggest that the combination of 4 mg ondansetron and 1.25 mg droperidol is more efficacious as a prophylactic anti-emetic than either agent alone during the 24 hr post-surgery. This additive effect may be due to the different mechanisms of action of ondansetron and droperidol.Objectif : Déterminer l'efficacité de l'ondansétron et du dropéridol, seuls ou combinés, administrés comme prophylaxie des nausées et vomissements postopératoires (NVPO) chez des patientes sous anesthésie générale lors d'une laparoscopie gynécologique en clinique externe.Méthode : Après avoir obtenu l'autorisation du Comité d'éthique médicale et le consentement des patientes, on a procédé à l'étude de 160 femmes, réparties au hasard en double aveugle, qui ont reçu avant la laparoscopie ambulatoire prévue : i) une solution salée (placebo), ii) 4 mg d'ondansétron, iii) 1,25 mg de dropéridol, ou iv) une combinaison intraveineuse de 4 mg d'ondansétron et de 1,25 mg de dropéridol à l'induction de l'anesthésie. Après l'anesthésie générale standard, les patientes ont été interrogées sur les NVPO à différents temps.Résultats : Pendant les 24 premières heures postopératoires, l'incidence des NVPO ont été de 71 % dans le groupe placebo. Cette incidence a été réduite à 61% avec de dropéridol employé seul (P = 0,334), à 46 % avec l'ondansétron seul (P = 0,027) et à 23 % avec la combinaison des deux médicaments (P < 0,001). Une différence statistiquement différente a été observée entre la combinaison et le dropéridol (P < 0,001) et entre la combinaison et l'ondansétron (P = 0,036). On enregistre moins de demandes de médication de rattrapage provenant des patientes qui ont reçu la combinaison de médicaments (7,7 %) que de celles qui ont reçu l'ondansétron ou le placebo.Conclusion : Les résultats de l'étude suggèr...

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“…1,5,6,7 whereas following gynecological laparoscopy it was reported to be found 36%-60%. 5,8,9,10,11,12 The benefits of an effective prophylaxis are apparent in such minor procedures, which are currently being done as daycare cases.…”

Section: Discussionmentioning

confidence: 99%

Effect of Oral Ondansetron in the Prevention of Postoperative Nausea and Vomiting Following Diagnostic Laparoscopy in Daycare Patients

Kuragayala¹,

Pasupuleti²,

Bhimeswar³

2015

jemds

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Postoperative nausea with or without vomiting is probably the most common complication of gynaecological diagnostic laparoscopy surgery performed under general anaesthesia. Ondansetron, a 5-hydroxytryptamine receptor subtype 3 (5HT3) antagonist, has been shown to be effective in the prevention and treatment of postoperative nausea and vomiting. Present study is undertaken to evaluate two doses of oral ondansetron in preventing postoperative nausea and vomiting. This double blind, randomized and placebo controlled study in ASA grade I and II daycare gynaecological patients conducted to evaluate the effectiveness of two doses of oral ondansetron (8mg) administered two hours prior to laparoscopy and repeated once 12 hours later. Frequency, severity of nausea and vomiting and side effects of ondansetron were noted. Oral ondansetron is significantly reduced the incidence and severity of post-operative nausea. The frequency and number of emetic episodes were also significantly reduced. Administration of oral ondansetron 8mg twice a day is a convenient and reliable method to effectively control postoperative nausea and vomiting in daycare patients.

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Nitrous oxide does not increase nausea and vomiting following gynaecological laparoscopy

Cited by 95 publications

References 7 publications

Prevention of nausea and vomiting after day case gynaecological laparoscopy

Prevention of nausea and vomiting after day case gynaecological laparoscopy

Additive anti-emetic efficacy of prophylactic ondansetron with droperidol in out-patient gynecological laparoscopy

Effect of Oral Ondansetron in the Prevention of Postoperative Nausea and Vomiting Following Diagnostic Laparoscopy in Daycare Patients

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