title: Prevention of nausea and vomiting after day case gynaecological laparoscopy. A comparison of ondansetron, droperidol, metoclopramide and placebo.
abstract: We have compared the efficacy of ondansetron, metoclopramide, droperidol and placebo in the prevention of postoperative nausea and vomiting in 118 day stay patients undergoing laparoscopic gynaecological procedures. All received a standardised general anaesthetic of fentanyl, propofol, nitrous oxide in oxygen and isoflurane. Three to five min before induction of anaesthesia, patients were allocated to receive ondansetron 4 mg, metoclopramide 10 mg, droperidol 1 mg or placebo in a randomised, double-blind manner. Visual analogue scores for nausea, the incidence of emetic episodes, and analgesic and antiemetic consumption were recorded for 48 h postoperatively. The scores for nausea were significantly lower in the ondansetron group (p < 0.01) compared with the other three groups at 1, 2 and 4 h after operation; thereafter there was no difference. The incidence of emesis was lower (p = 0.063) and time to first oral fluids was shorter (p < 0.05) in the ondansetron group. Oral analgesic requirements were significantly greater in the ondansetron group over the 48 h study period. Two patients, one each in the placebo and metoclopramide groups, had to remain in hospital overnight because of persistent emetic symptoms.
authors.affiliation: Department of Anaesthetics, Queen's University of Belfast, Northern Ireland.
authors.forename: L D
authors.initials: LD
authors.lastname: Paxton
authors.forename: A C
authors.initials: AC
authors.lastname: McKay
authors.forename: R K
authors.initials: RK
authors.lastname: Mirakhur
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D000768:Anesthesia, General; D004311:Double-Blind Method; D004329:Droperidol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008787:Metoclopramide / Q000627:therapeutic use; D009325:Nausea / Q000517:prevention & control*; D017294:Ondansetron / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D013246:Sterilization, Tubal; D014839:Vomiting / Q000517:prevention & control*
chemical_list: D017294:Ondansetron; D008787:Metoclopramide; D004329:Droperidol