Tropisetron for Treating Established Postoperative Nausea and Vomiting

Alon, Eli; Herrera, Eulo Lupi; Christiaens, Frank; Pauw, C. De; Ritter, Linda L.; Hulstaert, Frank; Grimaudo, V.

doi:10.1213/00000539-199803000-00034

Cited by 22 publications

(14 citation statements)

References 12 publications

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“…4) empfiehlt. Dies gilt für Ondansetron [17], Tropisetron [1], Granisetron [62] und auch für die Gabe von Dolasetron [43]. Auch in der Therapie von PONV bei Kindern sind die hierbei gebräuchlichen Dosierungen den Prophylaxedosierungen vergleichbar [38], sodass hier ebenso die Prophylaxedosierungen empfohlen werden.…”

Section: Therapie Von üBelkeit Und Erbrechen Nach Narkosenunclassified

Übelkeit und Erbrechen in der postoperativen Phase

et al. 2007

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There are no consensus guidelines for the management of postoperative nausea and vomiting (PONV) in German speaking countries. This meeting was intended to develop such guidelines on which individual health care facilities can derive their specific standard operating procedures (SOPs). Anesthesiologists reviewed published literature on key topics which were subsequently discussed during two meetings. It was emphasized that recommendations were based on the best available evidence. The clinical relevance of individual risk factors should be viewed with caution since even well proven risk factors, such as the history of PONV, do not allow the identification of patients at risk for PONV with a satisfactory sensitivity or specificity. A more useful approach is the use of simplified risk scores which consider the presence of several risk factors simultaneously. Most individual antiemetic interventions for the prevention of PONV have comparable efficacy with a relative risk reduction of about 30%. This appears to be true for total intravenous anesthesia (TIVA) as well as for dexamethasone and other antiemetics; assuming a sufficiently high, adequate and equipotent dosage which should be weight-adjusted in children. As the relative risk reduction is context independent and similar between the interventions, the absolute risk reduction of prophylactic interventions is mainly dependent on the patient's individual baseline risk. Prophylaxis is thus rarely warranted in patients at low risk, generally needed in patients with a moderate risk and should include a multimodal approach in patients at high risk for PONV. Therapeutic interventions of PONV should be administered promptly using an antiemetic which has not been used before. The group suggests algorithms where prophylactic interventions are mainly dependent on the patient's risk for PONV. These algorithms should provide evidence-based guidelines allowing the development of SOPs/policies which take local circumstances into account.

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Section: Therapie Von üBelkeit Und Erbrechen Nach Narkosenunclassified

Übelkeit und Erbrechen in der postoperativen Phase

et al. 2007

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“…Tropisetron has an elimination half-life of 8-12 h [136] and has been studied for prevention [137][138][139] and treatment [140] of PONV in adults. Tropisetron has been found effective for prevention of PONV after breast [137] and gynecologic surgery [138] when a 5-mg IV dose was administered prior to the start of anesthesia [137,138].…”

Section: Tropisetronmentioning

confidence: 99%

“…Zomers et al [139] determined that tropisetron 5 mg was effective for prevention of PONV following gynecological surgery. Alon et al [140] determined that tropisetron 2 mg IV was the optimal effective dose for the treatment of PONV following a variety of abdominal and non-abdominal surgeries (table 5).…”

Section: Tropisetronmentioning

confidence: 99%

Prevention and Treatment of Postoperative Nausea and Vomiting

Kovac¹

2003

Antiemetic Therapy

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“…Naguib et al [58] have evaluated the effectiveness of ondansetron 4 mg, granisetron 3 mg, and tropisetron 5 mg, compared with placebo, for the prevention of PONV after laparoscopic cholecystectomy, and demonstrated no difference in the number of patients who were emesis-free during 24 h after anesthesia among the ondansetron, granisetron, and tropisetron groups. In the treatment of established PONV, Alon et al [59] have compared the efficacy and tolerability of three doses (0.5, 2, and 5 mg) of i.v. tropisetron, and have determined that tropisetron 2 mg is the optimal dose.…”

Section: Introductionmentioning

confidence: 99%