Tropisetron for the Prevention of Postoperative Nausea and Vomiting in Women Undergoing Gynecologic Surgery

Alon, Eli; Kocián, Roman; Nett, Philipp C.; Koechli, Ossi R.; Baettig, Urs; Grimaudo, V.

doi:10.1097/00000539-199602000-00022

Cited by 35 publications

(19 citation statements)

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“…Fischer et al [30] and Alon et al [16] showed that tropisetron is more effective than placebo in preventing PONV after gynecologic operations. Pitkänen et al [31] applied bupivacaine (0.5%) and morphine (0.3 mg) to the subarachnoid space for postoperative analgesia; they could not find any significant difference between tropisetron and placebo groups.…”

Section: Discussionmentioning

confidence: 99%

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: 99%

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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“…Although 5‐HT 3 receptor antagonists have become clinically important agents in treating postoperative and chemotherapy‐induced nausea and emesis (Alon et al ., 1996; Tang et al ., 1998; Watters et al ., 2001) and in delaying large bowel transit and improving pain and discomfort associated with irritable bowel syndrome (Camilleri et al ., 2000), less attention has been paid to 5‐HT 3 receptor agonists as potential therapeutic agents. Consequently, future studies in this area will require suitable models of intestinal function.…”

Section: Introductionmentioning

confidence: 99%

Activation of 5‐HT₃ receptors in the rat and mouse intestinal tract: a comparative study

Chetty

Irving

Coupar

2006

British J Pharmacology

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1 This study provides a comprehensive evaluation of 5-HT 3 receptor functional distribution in both the rat and mouse intestinal tract. 2 5-HT 3AÀS receptor splice variant mRNA was expressed throughout the intestine of the rat and mouse; the 5-HT 3AÀL variant being more common in the rat. 3 5-HT, m-CPB, 1-PBG and 2-methyl-5-hydroxytryptamine (2m5-HT) induced contraction in the jejunum, ileum, proximal colon and distal colon of the rat (pEC 50 range: 2m5-HT, 5.8670.40 to m-CPB, 7.4770.27) and mouse (pEC 50 range: 1-PBG, 5.3470.06 to m-CPB, 6.4970.14) in the presence of nontarget 5-HT receptor antagonists, methysergide (1 mM) and GR125487 (0.1 mM). The rank orders of potency in the four regions of the rat and mouse intestine were concordant with the accepted order and the responses to 5-HT were inhibited by ondansetron (0.1 mM). 4 5-HT 3 -induced contractions to 5-HT were reduced by tetrodotoxin (1 mM). Pargyline (10 mM) and fluoxetine (1 mM) potentiated responses in the rat jejunum. Atropine (0.1 mM) potentiated 5-HT 3 -induced responses in the rat jejunum (E max 49-65%), but attenuated responses in most other regions of the rat and mouse (e.g. mouse ileum: E max 57-26%). In the rat jejunum, L-NAME (100 mM) mimicked the effect of atropine, hexamethonium (100 mM) suppressed 5-HT 3 -induced responses, but tachykinin receptor antagonists were without effect. 5 It is concluded that functional 5-HT 3 receptors are present in nerves along the length of the rat and mouse intestinal tract. The mouse proximal colon was found to discriminate 5-HT 3 receptor agonist profiles better than any other region in the rat or mouse. The rat jejunum shows evidence of 5-HT uptake and inactivation processes as well as inhibitory nitrergic and nontachykinin excitatory pathways associated with the 5-HT 3 -induced response.

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“…before the start of anesthesia has been found effective for prevention of PONV after breast and gynecologic surgery. [3940]…”

Section: Discussionmentioning

confidence: 99%

Granisetron versus tropisetron in the prevention of postoperative nausea and vomiting after total thyroidectomy

et al. 2013

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Background:Postoperative nausea and vomiting (PONV) are frequently encountered after thyroidectomy. For PONV prevention, selective serotonin 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists are considered one of the first-line therapy. We report on the efficiency of granisetron and tropisetron, with that of placebo on the prevention of PONV in patients undergoing total thyroidectomy.Methods:One hundred twenty-seven patients were divided into three groups and randomized to receive intravenously, prior to induction of anesthesia, tropisetron 5 mg, or granisetron 3 mg, or normal saline. All patients received additionally 0.625 mg droperidol. All episodes of postoperative PONV during the first 24 h after surgery were evaluated.Results:Nausea visual analogue scale (VAS) score was lower in tropisetron and granisetron groups than the control group at all measurements (P<0.01) except for the 8-h measurement for tropisetron (P=0.075). Moreover, granisetron performed better than tropisetron (P<0.011 at 4 h and P<0.01 at all other points of time) apart from the 2-h measurement. Vomiting occurred in 22.2%, 27.5%, and 37.5% in granisetron, tropisetron, and control groups, respectively (P=0.43).Conclusions:The combination of the 5-HT3 antagonists with droperidol given before induction of anesthesia is well tolerated and superior to droperidol alone in preventing nausea but not vomiting after total thyroidectomy.

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Tropisetron for the Prevention of Postoperative Nausea and Vomiting in Women Undergoing Gynecologic Surgery

Cited by 35 publications

References 10 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

Activation of 5‐HT₃ receptors in the rat and mouse intestinal tract: a comparative study

Granisetron versus tropisetron in the prevention of postoperative nausea and vomiting after total thyroidectomy

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Tropisetron for the Prevention of Postoperative Nausea and Vomiting in Women Undergoing Gynecologic Surgery

Cited by 35 publications

References 10 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

Activation of 5‐HT3 receptors in the rat and mouse intestinal tract: a comparative study

Granisetron versus tropisetron in the prevention of postoperative nausea and vomiting after total thyroidectomy

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Product

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Activation of 5‐HT₃ receptors in the rat and mouse intestinal tract: a comparative study