Dolasetron prophylaxis reduces nausea and postanaesthesia recovery time after remifentanil infusion during monitored anaesthesia care for extracorporeal shock wave lithotripsy.
BACKGROUND
Remifentanil is used as an analgesic for different procedures performed during monitored anaesthesia care. Opioid-induced nausea and vomiting can be troublesome.


METHODS
This prospective, randomized, double-blind study was performed to evaluate the efficacy of prophylaxis with dolasetron in reducing the frequency of postoperative nausea and duration of discharge time. Forty urological patients, undergoing elective ambulatory extracorporeal shock wave lithotripsy (ESWL) received randomly either dolasetron 12.5 mg i.v. (Group 1) or placebo (Group 2) 10 min before a patient-adapted continuous infusion of remifentanil 0.15-0.4 micro g kg(-1) min(-1) was administered. Frequency and intensity (VAS 0-100 mm) of nausea, retching, and vomiting were assessed by patients and blinded investigators during and after the procedure.


RESULTS
Patient characteristics, baseline values, duration of ESWL, and total dose of remifentanil did not differ between groups. The frequency (Group 1/Group 2; 20/55%; P<0.05) and mean (SD) maximal intensity [15 (9)/45 (14) mm; P<0.05] of nausea during 24 h was significantly reduced after dolasetron and discharge times in Group 1 were less than Group 2 [22 (14)/45 (28) min; P<0.05].
Burmeister
M A
MA
Department of Anesthesiology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany. burmeister@uke.uni-hamburg.de
Standl
T G
TG
Wintruff
M
M
Brauer
P
P
Blanc
I
I
Schulte am Esch
J
J
D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects; D000762:Anesthesia Recovery Period; D000771:Anesthesia, Intravenous / Q000379:methods; D000932:Antiemetics / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D007263:Infusions, Parenteral; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D017060:Patient Satisfaction; D010880:Piperidines / Q000008:administration & dosage / Q000009:adverse effects; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011446:Prospective Studies; D011807:Quinolizines / Q000627:therapeutic use*; D000077208:Remifentanil
D000701:Analgesics, Opioid; D000932:Antiemetics; D007211:Indoles; D010880:Piperidines; D011807:Quinolizines; C060344:dolasetron; D000077208:Remifentanil