Oral ondansetron in the prevention of postoperative nausea and vomiting.
The effect of three times daily oral ondansetron in preventing postoperative nausea and vomiting was investigated in two randomized, double-blind, placebo-controlled, multi-centre studies. The first study compared ondansetron 1, 8 and 16 mg to placebo, and the second study compared 8 mg ondansetron to placebo. Both studies included ASA Class I-III female patients about to undergo major abdominal gynaecological surgery or vaginal hysterectomy. In the first study, the 8 and 16 mg ondansetron groups had a significantly lower incidence of nausea and vomiting in the 0-24 h period following recovery from anaesthesia than the placebo group. Ondansetron 8 mg three times daily was also significantly better than placebo in the second study. Side-effects mainly consisted of constipation, headache, and asymptomatic elevation of liver enzymes. The incidence of side-effects was similar in ondansetron- and placebo-treated patients. There appeared to be no clinically important benefit of the 16 mg three times daily ondansetron regimen over the 8 mg three times daily dose, therefore 8 mg three times daily is recommended as the optimal oral dose in the prevention of postoperative nausea and vomiting.
Department of Anaesthesiology, Ziekenhuis de Lichtenberg, Amersfoort, The Netherlands.
J H
JH
Helmers
D000284:Administration, Oral; D000328:Adult; D000410:Alanine Transaminase / Q000032:analysis; D001219:Aspartate Aminotransferases / Q000032:analysis; D003248:Constipation / Q000139:chemically induced; D004311:Double-Blind Method; D006261:Headache / Q000139:chemically induced; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009325:Nausea / Q000517:prevention & control*; D017294:Ondansetron / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010919:Placebos; D011183:Postoperative Complications / Q000517:prevention & control*; D012449:Safety; D013997:Time Factors; D014839:Vomiting / Q000517:prevention & control*; D005723:gamma-Glutamyltransferase / Q000032:analysis
D010919:Placebos; D017294:Ondansetron; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase