Ondansetron 4 mg for the Prevention of Nausea and Vomiting after Minor Laparoscopic Gynaecological Surgery

Abstract

We studied the efficacy and safety of intravenous ondansetron 4 mg for the prevention of postoperative nausea and vomiting after minor gynaecological laparoscopic surgery in Oriental women. This double-blind randomised study compared ondansetron with placebo, given before the induction of anaesthesia. The anaesthetic technique used thiopentone, fentanyl, atracurium, nitrous oxide and isoflurane. Patients were studied for 24 h with nausea assessed using a verbal numeric scale from 0-10 and emetic episodes recorded as they occurred. Results were available for 102 patients in each group. In the first postoperative hour, fewer patients in the ondansetron Group (12%) had emetic episodes compared with the placebo group (33%, P <0.01). Nausea score over the first hour (sum of three readings at 0, 30 and 60 min) was lower in the ondansetron group (median 1.6) compared with the placebo group (3.1, P <0.05). Over the 24 h period, fewer patients in the ondansetron group had emetic episodes (25%) or nausea (43%) compared with patients in the placebo group (56%, P <0.01) and (58%, P <0.05) respectively. No adverse events were seen. Ondansetron 4 mg was more effective than placebo in preventing postoperative nausea and vomiting throughout the 24 h after minor laparoscopic surgery.

Eficácia do ondansetron, metoclopramida, droperidol e dexametasona na prevenção de náusea e vômito após laparoscopia ginecológica em regime ambulatorial. Estudo comparativo

“…Ondansetron was the most effective drug in preventing postoperative nausea (4.55%) and vomiting (5.26%), which is in line with other authors 8-10, [13][14][15] . From all drugs studied, droperidol was the closest to ondansetron in preventing nausea (5.27%) and vomiting (9.09%) after videolaparoscopic gynecological procedures, in the conditions of this study.…”

The effectiveness of rescue antiemetics after failure of prophylaxis with ondansetron or droperidol: a preliminary report

“…In a multicenter study, Kovac et al [3] reported that, in patients who failed prophylaxis with ondansetron 4 mg, a repeat dose of ondansetron 4 mg was no better than placebo for the treatment of established PONV. Although 2 other studies attempted to investigate redosing the agent used for prophylaxis for the treatment of PONV as part of a PONV prophylaxis study, the number of patients who experienced PONV was very small (b10) and, therefore, no meaningful conclusions could be drawn [4,5].…”

Prophylactic ondansetron for post-operative emesis: meta-analysis of its effectiveness in patients with and without a previous history of motion sickness

“…The meta‐analysis included 1247 patients in the ondansetron group and 875 patients in the placebo group (173 of these patients pertaining to two studies [21, 41] had been used simultaneously to compare the different doses of ondansetron). Four of the studies [18, 21, 46, 56], involving 698 patients treated with ondansetron and 524 with placebo were sponsored by the manufacturer.…”