title: Effect of propofol for induction and ondansetron with or without dexamethasone for the prevention of nausea and vomiting after major gynecologic surgery.
abstract: OBJECTIVE
  To test the hypothesis that for major gynecologic surgery the combination of propofol for induction, ondansetron, and dexamethasone would be a more effective antiemetic combination than propofol for induction, ondansetron, and saline; and to determine if a propofol induction of anesthesia improved our previously reported results when thiamylal was the induction drug.
  
  
  METHODS
  Double-blind, randomized study.
  
  
  METHODS
  Magee-Womens Hospital, Pittsburgh, Pennsylvania.
  
  
  METHODS
  80 healthy ASA physical status I, II, and III female inpatients scheduled for major gynecologic surgery.
  
  
  METHODS
  After induction of anesthesia with propofol, Group 1 received intravenous (IV) ondansetron 4 mg and saline, and Group 2 received IV ondansetron 4 mg followed by IV dexamethasone 20 mg.
  
  
  RESULTS
  For Group 1 and Group 2, respectively, no emesis and no rescue occurred in 15 (37.5%) and 21 (52.5%) patients (p = 0.13); emesis occurred in 7 (17.5%) Group 1 patients and 5 (12.5%) Group 2 patients, rescue antiemetic 23 (57.5%) Group 1 patients and 19 (47.5%) Group 2 patients. Nausea was reported by 31 (77.5%) Group 1 patients and 30 (75%) Group 2 patients.
  
  
  CONCLUSIONS
  The hypothesis that the addition of dexamethasone to the propofolondansetron combination would significantly reduce postoperative nausea and vomiting (PONV) was not confirmed. A propofol induction of anesthesia resulted in a comparable incidence of PONV when compared with our previously reported results using thiamylal for induction of anesthesia for women having major gynecologic operations.
authors.affiliation: Department of Anesthesiology, Magee-Womens Hospital, Pittsburgh, PA 15213, USA.
authors.forename: R
authors.initials: R
authors.lastname: McKenzie
authors.forename: T J
authors.initials: TJ
authors.lastname: Riley
authors.forename: B
authors.initials: B
authors.lastname: Tantisira
authors.forename: D L
authors.initials: DL
authors.lastname: Hamilton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous; D000932:Antiemetics / Q000627:therapeutic use*; D003907:Dexamethasone / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005836:Genitalia, Female / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D009325:Nausea / Q000517:prevention & control; D017294:Ondansetron / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D015742:Propofol; D012890:Sleep / Q000187:drug effects; D014839:Vomiting / Q000517:prevention & control
chemical_list: D018686:Anesthetics, Intravenous; D000932:Antiemetics; D017294:Ondansetron; D003907:Dexamethasone; D015742:Propofol