Dolasetron (12.5 mg IV) is effective in both preventing and treating
postoperative nausea and vomiting (
PONV) after
ambulatory surgery. However, the optimal timing of
dolasetron administration and its effect on the patient's quality of life after discharge have not been established. One-hundred-five healthy, consenting women undergoing gynecologic laparoscopic procedures with a standardized
general anesthetic technique were enrolled in this randomized, double-blinded study. Group 1 received
dolasetron 12.5 mg IV 10-15 min before the induction of
anesthesia; Group 2 received
dolasetron 12.5 mg IV at the end of the laparoscopy (79 +/- 48 min later than Group 1); and Group 3 received
dolasetron 12.5 mg IV at the end of
anesthesia (93 +/- 52 min later than Group 1). The incidence of
PONV, complete responses (defined as no
emetic episodes and no rescue medication within the 24-h period after
anesthesia), recovery profiles, and patient satisfaction were recorded. In the postanesthesia care unit and during the 24-h follow-up period, the incidence of
nausea and
vomiting, as well as the need for rescue
antiemetics, did not differ significantly among the three groups. The percentages of patients with complete responses to the study drug within the first postoperative 24 h were also similar in all three groups (55%, 59%, and 52% for Groups 1, 2, and 3, respectively). The early and intermediate recovery profiles, including resumption of a normal diet and patient satisfaction with the control of
PONV, were not different among the three study groups.
Dolasetron 12.5 mg IV administered before the induction of
anesthesia is as effective as
dolasetron given at the end of laparoscopy or at the end of
anesthesia in preventing
PONV after outpatient laparoscopy.
IMPLICATIONS: