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Postoperative nausea and vomiting after surgery for prognathism: not only a question of patients' comfort. A placebo-controlled comparison of dolasetron and droperidol.

AbstractINTRODUCTION:
The aim of this study was to evaluate the efficacy of dolasetron and droperidol (DHB) for preventing postoperative nausea and vomiting (PONV) in patients undergoing surgery for prognathism.
MATERIAL AND METHODS:
In a randomised, placebo-controlled, double-blind trial, the efficacy of 12.5 mg dolasetron i.v. and 1.25 mg DHB was evaluated in preventing PONV in 83 patients undergoing surgery for prognathism. Patients were allocated randomly to one of three groups: group A (n=27) received 12.5 mg dolasetron intravenously (i.v.), group B (n=27) received 1.25 mg DHB i.v. and placebo group C (n=29) received saline 0.9%. If patients complained of retching or vomiting or if patients demanded antiemetics, 20mg metoclopramide (MCP) i.v. was given. Postoperative nausea, postoperative vomiting, or nausea and vomiting was assessed in the postoperative period at 0-4 h and overall between 0 and 24 h.
RESULTS:
A significant reduction in the incidence of postoperative nausea and/or vomiting was observed in the dolasetron group (33%) when compared with DHB (81%) and placebo (86%) treated patients. No other significant differences between the DHB and the placebo group were found. Dolasetron (11%) significantly reduced vomiting in comparison with the DHB (52%) and placebo group (52%). The use of postoperative MCP per patient was significantly lower in the dolasetron group when compared with both other groups. Dolasetron significantly reduced the postoperative nausea and/or vomiting-score when compared with both other groups. There was no significant difference between DHB- and placebo-treated patients with regard to nausea and/or vomiting.
CONCLUSION:
Intravenous dolasetron (12.5 mg) is more effective than either intravenous DHB (1.25 mg) or placebo for preventing PONV after surgery for prognathism. It also was significantly superior to either DHB or placebo concerning nausea and vomiting and the need for MCP rescue medication.
AuthorsSwen N Piper, Kerstin Röhm, Joachim Boldt, Peter Kranke, Wolfgang Maleck, Rudolf Seifert, Stefan Suttner
JournalJournal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery (J Craniomaxillofac Surg) Vol. 36 Issue 3 Pg. 173-179 (Apr 2008) ISSN: 1010-5182 [Print] Scotland
PMID18353666 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
Chemical References
  • Antiemetics
  • Dopamine Antagonists
  • Indoles
  • Placebos
  • Quinolizines
  • Serotonin Antagonists
  • dolasetron
  • Metoclopramide
  • Droperidol
Topics
  • Adult
  • Antiemetics (administration & dosage, therapeutic use)
  • Dopamine Antagonists (administration & dosage, therapeutic use)
  • Double-Blind Method
  • Droperidol (administration & dosage, therapeutic use)
  • Female
  • Follow-Up Studies
  • Humans
  • Indoles (administration & dosage, therapeutic use)
  • Injections, Intravenous
  • Male
  • Metoclopramide (administration & dosage, therapeutic use)
  • Placebos
  • Postoperative Nausea and Vomiting (classification, prevention & control)
  • Prognathism (surgery)
  • Quinolizines (administration & dosage, therapeutic use)
  • Serotonin Antagonists (administration & dosage, therapeutic use)
  • Treatment Outcome

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