To evaluate the efficacy of prophylactic transdermal
scopolamine in reducing
nausea associated with postoperative
epidural analgesia, we studied 32 healthy adult women undergoing major
gynecologic surgery. The patients were randomized in a double blind fashion to receive either a cutaneous
scopolamine patch or a visually identical cutaneous placebo patch. Postoperative
analgesia was provided solely with epidural
morphine.
Nausea was treated with
metoclopramide and
droperidol. At 24 hours postoperatively, the mean
nausea score was significantly lower with
scopolamine than with placebo (1 +/- 2 vs 51 +/- 42, respectively, P less than 0.05). The number of patients reporting "zero
nausea" was significantly greater with
scopolamine patches than with placebo patches (13 vs 1, P less than 0.01). The mean number of times
antiemetic drugs were administered per patient was lower with
scopolamine than with placebo patches (0.2 +/- 0.4 vs 2.8 +/- 2.6, P less than 0.05). It is concluded that prophylactic transdermal
scopolamine patches reduce
nausea in postoperative patients receiving epidural
morphine.