Optimization of anesthesia antiemetic measures versus combination therapy using dexamethasone or ondansetron for the prevention of postoperative nausea and vomiting

Abstract

Ondansetron or dexamethasone added to collective anesthetic antiemetic measures does not further decrease the incidence of PONV after laparoscopic cholycestectomy.

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“…These two complaints are among the most frequent causes of hospitalization and the inability to discharge patients scheduled for ambulatory procedures. Additionally, these symptoms are among the most feared by patients undergoing minor surgery, surpassing even postoperative pain (30). …”

Practice Guidelines for Postanesthetic Care

“…Meta-analyses of new double-blind RCTs comparing dexamethasone with placebo controls corroborate findings reported in the original Guidelines indicating that this antiemetic is effective in the prophylaxis of postoperative vomiting and reduced use of rescue antiemetics, and for the prophylaxis of nausea when higher doses are administered (Category A1-B evidence). 8,12,24,26,29,36,37,39,41,43,44,[47][48][49][50][51][52][53][54][55][56] The consultants and ASA members agree that the pharmacologic prophylaxis of nausea and vomiting improves patient comfort and satisfaction, reduces time to discharge, and should be done selectively. Multiple Pharmacologic Agents for Prophylaxis of Nausea and Vomiting.…”

“…Drugs evaluated by these Guidelines for the prophylaxis of nausea and vomiting include: (1) antihistamines, (2) 5-HT3 antiemetics, (3) tranquilizers/neuroleptics, (4) metoclopramide, (5) scopolamine, and (6) 2-6 granisetron (reduced vomiting), [7][8][9][10][11] ondansetron (reduced vomiting and rescue antiemetics), [7][8][9][12][13][14][15][16][17][18][19][20][21][22][23][24] and tropisetron (reduced vomiting and rescue antiemetics).…”

Manual de práctica clínica basado en la evidencia: Controles posquirúrgicos

“…Los medicamentos específicos son: dolasetrón (reduce el vómito) [23][24][25][26][27] , granisetrón (reduce el vómito) 28-32 y ondansetrón (reduce el vómito y rescates antieméticos) [28][29][30][33][34][35][36][37][38][39][40][41][42][43][44][45] .…”

“…El metaanálisis de ECC reporta que este antiemético es efectivo en la profilaxis del vómito postoperatorio (reduce el uso de antieméticos de rescate) y como profilaxis de náusea (se observó efectividad a mayores dosis) (evidencia categoría A1-B) 29,33,45,48,49,51,52,[54][55][56][57][58][59][60][61][62][63][64][65][66][67] .…”