[The efficacy of droperidol, metoclopramide, propofol, and ondansetron for the prevention of nausea and vomiting following middle ear surgery].
OBJECTIVE
The efficacy and reliability of prophylactic antiemetic therapy with low dose propofol, droperidol, metoclopramide, and ondansetron were evaluated in a randomized, double-blind, and prospective design.


METHODS
A total of 101 ASA I-II patients (34 females, 67 males; age range 16 to 53 years) undergoing middle ear surgery for chronic otitis media or its sequelae were randomly assigned to receive prophylactic antiemetic therapy with propofol (n=21, 0.5 mg/kg), droperidol (n=19, 20 mg/kg), metoclopramide (n=23, 0.2 mg/kg), ondansetron (n=21, 4 mg), and placebo (n=20, 0.9% NaCl). All drugs were administered intravenously five minutes before extubation.


RESULTS
In the early postoperative period (0 to 3 hours), the percentages of patients free from nausea and vomiting were 100% with droperidol, 71.4% with ondansetron and propofol, 52.1% with metoclopramide, and 35% with placebo. Ondansetron (90.4%) was found the most effective to prevent and control nausea and vomiting during the postoperative 3 to 24 hours, followed by droperidol (84.2%), propofol (57.1%), metoclopramide (47.8%), and placebo (40%). Compared with controls, the number of patients without nausea and vomiting was significantly greater in each treatment group but metoclopramide (p<0.05). No significant differences were detected with respect to adverse effects.


CONCLUSIONS
Droperidol and ondansetron seem to exert the highest efficacy to prevent nausea and vomiting during the postoperative 0 to 3 hours and 3 to 24 hours, respectively.
Karlidağ
Turgut
T
Department of Otolaryngology, Medicine Faculty of Firat University, Elaziğ - Turkey. turgut_karlidag@yahoo.com
Kaygusuz
Irfan
I
Bestaş
Azize
A
Keleş
Erol
E
Demirbağ
Erhan
E
Yalçin
Sinasi
S
D000293:Adolescent; D000328:Adult; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use*; D002908:Chronic Disease; D004311:Double-Blind Method; D004329:Droperidol / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007432:Intraoperative Period; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D017294:Ondansetron / Q000008:administration & dosage / Q000627:therapeutic use; D010033:Otitis Media / Q000601:surgery*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D015742:Propofol / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D016896:Treatment Outcome
D000932:Antiemetics; D017294:Ondansetron; D008787:Metoclopramide; D004329:Droperidol; D015742:Propofol