Oral ondansetron, tropisetron or metoclopramide to prevent postoperative nausea and vomiting: a comparison in high‐risk patients undergoing thyroid or parathyroid surgery

Jokela, R.; Koivuranta, M.; Kangas-Saarela, T.; Purhonen, Sinikka; Alahuhta, Seppo

doi:10.1034/j.1399-6576.2002.460508.x

Cited by 32 publications

(24 citation statements)

References 17 publications

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“…We found sedation in 3 patients and hypotension in 1 patient in this study. Droperidol has been reported to induce sedation, hypotension, and extrapyramidal side effects [11,14]; we found sedation in 5 patients, hypotension in 4 patients, and headache in 1 patient in this group.…”

Section: Discussionmentioning

confidence: 61%

“…Acceptable medications for antiemetic prophylaxis must have a duration of action covering the perioperative period and have minimal side effects [10,11]. The optimum drug dosage for PONV prophylaxis with minimal side effects has been studied using 0.15–0.25 mg/kg i.v.…”

Section: Discussionmentioning

confidence: 99%

“…[12,13], droperidol 0.014–0.075 mg/kg i.v. [11,14], tropisetron 5 mg i.v. [15,16], and ondansetron 4 mg i.v.…”

Section: Discussionmentioning

confidence: 99%

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A Randomized Comparison of Droperidol, Metoclopramide, Tropisetron, and Ondansetron for the Prevention of Postoperative Nausea and Vomiting

Ekinci

Malat

Işıtmangil

et al. 2010

Gynecol Obstet Invest

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Background: Nausea and vomiting are the most common causes of postoperative complications, and they are seen most often after operations performed using general anesthesia and sedation. We designed this study to compare the effects of droperidol, metoclopramide, tropisetron, and ondansetron for the prevention of postoperative nausea and vomiting in patients undergoing gynecologic operations. Methods: One hundred patients were randomly assigned to 1 of 5 groups: group D was given 2.5 mg droperidol; group M, 10 mg metoclopramide; group T, 2.5 mg tropisetron; group O, 4 mg ondansetron 5 min after induction, and group C was the control group and received no prophylactic antiemetic treatment. All patients were observed for sedation and postoperative nausea and vomiting for 48 h. Results: Within 24 h after the operation, severe postoperative nausea and vomiting were seen in 4 patients (20%) in group D, 8 (40%) in group M, 5 (25%) in group T, 3 (15%) in group O, and 12 patients (60%) in the control group. Patients receiving droperidol, tropisetron, and ondansetron had significantly less serious emesis than the control group (p < 0.05). Sedation was seen in 5 patients receiving droperidol (4 patients score 2; and 1 patient score 3) and tropisetron (2 patients score 2; and 3 patients score 3) 15 min after surgery; this was significantly higher than in the control group (p < 0.05). Conclusion: We conclude that metoclopramide is not effective in preventing postoperative nausea and vomiting after gynecologic operations. Droperidol, tropisetron, and ondansetron are effective; however, the sedating effects of droperidol and tropisetron should be considered.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

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A Randomized Comparison of Droperidol, Metoclopramide, Tropisetron, and Ondansetron for the Prevention of Postoperative Nausea and Vomiting

Ekinci

Malat

Işıtmangil

et al. 2010

Gynecol Obstet Invest

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“…In thyroid surgery, the selective 5-hydroxytryptamine type 3 (5-HT 3 ) receptor antagonists granisetron, ondansetron, and tropisetron are considered superior to traditional antiemetic agents [8,9]. However, to date, the efficacies of these three different serotonin antagonists have not been compared.…”

Section: Introductionmentioning

confidence: 97%

Antiemetic prophylaxis in thyroid surgery: a randomized, double-blind comparison of three 5-HT3 agents

et al. 2011

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“…49 Dolasetron 12.5 mg was also found to have similar efficacy to ondansetron 4 mg with a similar side effect profile for the prevention of PONV. 50,51 In an earlier study, dolasetron 50 mg had similar efficacy to ondansetron 4 mg. 52 Similarly, in a multicentre trial, it was demonstrated that 2 mg tropisetron intravenously had similar efficacy and side effect profiles to those of ondansetron 4 mg. 53 This was confirmed in another two trials comparing iv tropisetron 5 mg with ondansetron 4 mg and oral tropisetron 5 mg with ondansetron 16 mg. 54,55 Fujii and colleagues compared the antiemetic efficacy of granisetron 2.5 to 3 mg and ramosetron 0.3 mg in three studies. There was no difference between the two agents in achieving a complete response (no PONV and no antiemetic rescue) during the first 24 hr postoperatively.…”

Section: Receptor Antagonistsmentioning

confidence: 99%

Evidence-based management of postoperative nausea and vomiting: a review

Habib

Gan

2004

Can J Anesth/J Can Anesth

196

106

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P Pu ur rp po os se e: : To provide evidence-based guidelines for the prophylaxis and treatment of postoperative nausea and vomiting (PONV).S So ou ur rc ce e: : Literature from randomized controlled trials, systematic reviews, logistic regression analyses and expert opinion in the management of PONV.P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : The etiology of PONV is multifactorial. Patient, anesthesia, and surgery related risk factors have been identified. Universal PONV prophylaxis is not cost-effective. Identification of patients at high-risk of PONV allows targeting prophylaxis to those who will benefit most from it. No prophylaxis is needed for patients at low risk for PONV. For patients at moderate risk for PONV, prophylaxis using a single antiemetic or a combination of two agents should be considered. Double and triple antiemetic combinations should be considered for patients at high risk for PONV. Furthermore, a multimodal approach should be adopted incorporating steps to keep the baseline risk of PONV low. The optimum cost-effective approach to the management of PONV will differ between an ambulatory centre and an inpatient hospital setting. For the treatment of established PONV in patients who failed prophylaxis, patients should not receive a repeat dose of the prophylactic antiemetic. Rather, a drug acting at a different receptor should be used. Beyond six hours after surgery, patients can be treated with any of the agents used for prophylaxis, except dexamethasone and transdermal scopolamine.C Co on nc cl lu us si io on n: : PONV are common after anesthesia and surgery. We provided evidence-based guidelines for the management of this problem based on the available literature. Objectif : Énoncer des lignes de conduite fondées sur des données probantes pour la prévention et le traitement des nausées et des vomissements postopératoires (NVPO). Source : Les publications d'essais contrôlés et randomisés, les études méthodiques, les analyses de régression logistique et l'opinion d'experts sur le traitement des NVPO. Constatations principales : L'origine des NVPO est multifactorielle. Les facteurs de risque reliés au patient, à l'anesthésie et au type de chirurgie sont connus. La prévention universelle des NVPO n'est pas rentable. L'identification des patients à haut risque de NVPO permet

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Oral ondansetron, tropisetron or metoclopramide to prevent postoperative nausea and vomiting: a comparison in high‐risk patients undergoing thyroid or parathyroid surgery

Cited by 32 publications

References 17 publications

A Randomized Comparison of Droperidol, Metoclopramide, Tropisetron, and Ondansetron for the Prevention of Postoperative Nausea and Vomiting

A Randomized Comparison of Droperidol, Metoclopramide, Tropisetron, and Ondansetron for the Prevention of Postoperative Nausea and Vomiting

Antiemetic prophylaxis in thyroid surgery: a randomized, double-blind comparison of three 5-HT3 agents

Evidence-based management of postoperative nausea and vomiting: a review

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