Abstract | BACKGROUND: We compared two antiemetic prophylaxis regimens, their efficacy for preventing postdischarge nausea and vomiting, and their impact on quality of living, during recovery. METHODS: Sixty-four women undergoing outpatient gynecological surgery and at high risk for emesis were randomized into one of two groups. The study group received intraoperative IV dexamethasone 8 mg and ondansetron 4 mg, followed with an 8 mg oral disintegrating ondansetron tablet, to be taken on discharge and in the morning of postoperative days 1 and 2. The control group received only the IV ondansetron 4 mg intraoperatively. The incidence and severity of emetic symptoms and pain were assessed while patients were in the recovery room and via telephone and patient diary for 5 days after discharge. A modified functional living index of emesis was used to assess the impact on quality of living during recovery. RESULTS: Sixty patients, 30 in each group, completed the study. The incidences for postdischarge nausea were 57% and 20%, and for postdischarge vomiting 20% and 3% in the control and study groups, respectively, for the period between the 8th and 120th hours postanesthesia (P < 0.05). Thirty-three percent of the study and 60% of the control group reported that emetic symptoms negatively affected their quality of living (P < 0.05). CONCLUSIONS: When compared with a single dose of intraoperative IV ondansetron prophylaxis, our study regimen of additional intraoperative dexamethasone and once a day ondansetron significantly reduced the incidence of postdischarge nausea and vomiting and its negative impact on quality of living during the first 5 days of recovery.
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Authors | Peter H Pan, Sherman C Lee, Lynne C Harris |
Journal | Anesthesia and analgesia
(Anesth Analg)
Vol. 107
Issue 2
Pg. 429-38
(Aug 2008)
ISSN: 1526-7598 [Electronic] United States |
PMID | 18633020
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antiemetics
- Ondansetron
- Dexamethasone
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Topics |
- Administration, Oral
- Adult
- Ambulatory Surgical Procedures
- Antiemetics
(administration & dosage)
- Dexamethasone
(administration & dosage)
- Double-Blind Method
- Drug Administration Schedule
- Female
- Gynecologic Surgical Procedures
- Humans
- Infusions, Intravenous
- Ondansetron
(administration & dosage)
- Pain, Postoperative
(drug therapy)
- Patient Discharge
- Postoperative Nausea and Vomiting
(prevention & control)
- Quality of Life
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