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Antiemetic prophylaxis for postdischarge nausea and vomiting and impact on functional quality of living during recovery in patients with high emetic risks: a prospective, randomized, double-blind comparison of two prophylactic antiemetic regimens.

AbstractBACKGROUND:
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.
AuthorsPeter H Pan, Sherman C Lee, Lynne C Harris
JournalAnesthesia and analgesia (Anesth Analg) Vol. 107 Issue 2 Pg. 429-38 (Aug 2008) ISSN: 1526-7598 [Electronic] United States
PMID18633020 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Antiemetics
  • Ondansetron
  • Dexamethasone
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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