Transdermal scopolamine reduces nausea and vomiting after outpatient laparoscopy.
The authors evaluated the effect of transdermal scopolamine on the incidence of postoperative nausea, retching, and vomiting after outpatient laparoscopy in a double-blind, placebo-controlled study. A Band-Aid-like patch containing either scopolamine or placebo was placed behind the ear the night before surgery. Anesthesia was induced with fentanyl (0.5-2 micrograms/kg iv), thiopental (3-5 mg/kg iv), and succinylcholine (1-1.5 mg/kg iv) and maintained with isoflurane (0.2-2%) and nitrous oxide (60%) in oxygen. Scopolamine-treated patients had less nausea, retching, and vomiting compared with placebo-treated patients (P = 0.0029). Severe nausea and/or vomiting was present in 62% of the placebo group but only 37% of those getting the scopolamine patch. Repeated episodes of retching and vomiting were also less frequent in the scopolamine group compared with the placebo group (23% vs. 41%; P = 0.0213) as was the need for additional antiemetic therapy (13% vs. 32%; P = 0.0013). Patients in the scopolamine group were also discharged from the hospital sooner (4 +/- 1.3 vs. 4.5 +/- 1.5 h; P = 0.0487). Side effects were more frequent among those patients treated with the scopolamine patch (91% vs. 45%; P less than 0.05) but were not troublesome. The authors conclude that transdermal scopolamine is a safe and effective antiemetic for outpatients undergoing laparoscopy.
Bailey
P L
PL
Department of Anesthesiology, University of Utah School of Medicine, Salt Lake City 84132.
Streisand
J B
JB
Pace
N L
NL
Bubbers
S J
SJ
East
K A
KA
Mulder
S
S
Stanley
T H
TH
D000279:Administration, Cutaneous; D000328:Adult; D000556:Ambulatory Surgical Procedures; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D010535:Laparoscopy; D009325:Nausea / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D012601:Scopolamine / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D014839:Vomiting / Q000517:prevention & control*
D012601:Scopolamine