title: Intramuscular ephedrine reduces emesis during the first three hours after abdominal hysterectomy.
abstract: BACKGROUND
  We tested the hypothesis that intramuscularly administered ephedrine prevents postoperative nausea and vomiting. Ephedrine is cheap, and for this indication poorly documented.
  
  
  METHODS
  One hundred and nine patients undergoing elective abdominal hysterectomy under general anaesthesia were studied in a randomized, double-blind placebo-controlled study. Ten minutes before the end of the procedure patients received either ephedrine 0.5 mg/kg i.m. or placebo. The patients were closely observed for 24 h for postoperative nausea or vomiting (PONV) and received a standardized two-step antiemetic treatment of i.v. metoclopramide 10 mg, supplemented with ondansetron 4 mg i.v. if needed.
  
  
  RESULTS
  The ephedrine treated patients had significantly less nausea, retching and vomiting, and need of antiemetic rescue during the first 3 h postoperatively compared with the placebo patients. No difference between the groups was evident in the 3-24 h postoperative observation period. All the patients with PONV during 0-3 h experienced PONV in the 3-24 h period. Treatment or prophylaxis with one drug was less efficient than two or more drugs combined. No significant differences in hypotension, tachycardia or other side-effects between the groups were noted.
  
  
  CONCLUSIONS
  Ephedrine 0.5 mg/kg i.m. administered at the end of abdominal hysterectomy has a significant antiemetic effect during the first 3 h after administration with no evident side-effects.
authors.affiliation: Department of Anaesthesia, Central Hospital of Vest-Agder, Norway.
authors.forename: E
authors.initials: E
authors.lastname: Hagemann
authors.forename: A
authors.initials: A
authors.lastname: Halvorsen
authors.forename: O
authors.initials: O
authors.lastname: Holgersen
authors.forename: T
authors.initials: T
authors.lastname: Tveit
authors.forename: J C
authors.initials: JC
authors.lastname: Raeder
mesh_terms: D004311:Double-Blind Method; D004809:Ephedrine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007273:Injections, Intramuscular; D008875:Middle Aged; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D004809:Ephedrine