Effect of propofol for induction and ondansetron with or without dexamethasone for the prevention of nausea and vomiting after major gynecologic surgery.
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.
McKenzie
R
R
Department of Anesthesiology, Magee-Womens Hospital, Pittsburgh, PA 15213, USA.
Riley
T J
TJ
Tantisira
B
B
Hamilton
D L
DL
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
D018686:Anesthetics, Intravenous; D000932:Antiemetics; D017294:Ondansetron; D003907:Dexamethasone; D015742:Propofol