Prophylactic antiemetics for laparoscopic cholecystectomy: ondansetron versus droperidol plus metoclopramide.
Two hundred adults undergoing laparoscopic cholecystectomy were enrolled in a prospectively randomized, double-blind investigation comparing ondansetron, 4 mg (Group O) with the combination of droperidol, 0.625 mg, and metoclopramide, 10 mg (Group DM). Antiemetic drugs were administered intravenously (IV) after induction of general anesthesia (propofol, desflurane). Moderate or severe nausea in the postanesthesia care unit was treated with the cross-over drug, i.e., ondansetron for patients in Group DM or droperidol plus metoclopramide for patients in Group O. Data were analyzed using t-tests and chi 2 analyses, with P < 0.05 considered statistically significant. The groups were similar with respect to gender, age, weight, duration of surgery, number receiving intraoperative atropine or ephedrine, number admitted over-night, and time to discharge home. Of 102 patients in Group O, 44 required antiemetics in the postanesthesia care unit, compared with 24 of 98 patients in Group DM (P < 0.01). One patient (in Group DM) was admitted for persistent nausea. In conclusion, droperidol 0.625 mg IV in combination with metoclopramide 10 mg IV was more effective in preventing postoperative nausea than was ondansetron 4 mg IV in patients undergoing laparoscopic cholecystectomy, with no difference in the time to discharge.
Department of Anesthesia, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
R A
RA
Steinbrook
D
D
Freiberger
J L
JL
Gosnell
D C
DC
Brooks
D000322:Adrenergic Agonists / Q000008:administration & dosage; D000328:Adult; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use*; D001285:Atropine / Q000008:administration & dosage; D018890:Chemoprevention; D017081:Cholecystectomy, Laparoscopic; D018592:Cross-Over Studies; D004329:Droperidol / Q000008:administration & dosage / Q000627:therapeutic use*; D004338:Drug Combinations; D004809:Ephedrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007430:Intraoperative Care; D007902:Length of Stay; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage / Q000627:therapeutic use*; D018727:Muscarinic Antagonists / Q000008:administration & dosage; D009325:Nausea / Q000517:prevention & control; D017294:Ondansetron / Q000008:administration & dosage / Q000627:therapeutic use*; D010343:Patient Admission; D010351:Patient Discharge; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D014839:Vomiting / Q000517:prevention & control
D000322:Adrenergic Agonists; D000932:Antiemetics; D004338:Drug Combinations; D018727:Muscarinic Antagonists; D017294:Ondansetron; D001285:Atropine; D004809:Ephedrine; D008787:Metoclopramide; D004329:Droperidol