Comparative study of the antiemetic efficacy of ondansetron, propofol and midazolam in the early postoperative period.
OBJECTIVE
To compare the antiemetic efficacy of ondansetron with two different hypnotic drugs (propofol 15 mg, midazolam 1 and 2 mg) for the treatment of established postoperative nausea and vomiting (PONV).


METHODS
Four-hundred-and-fifty-three patients scheduled for elective gynaecological or abdominal surgery were enrolled. One-hundred-and-twenty patients (26%) experienced postoperative emesis, and when nausea scores reached 2 or greater on a five-point scale, they were randomized to receive intravenously: propofol 15 mg (1.5 mL) in Group P, midazolam 1 mg in Group M1, midazolam 2 mg in Group M2 and ondansetron 4 mg in Group O.


RESULTS
Four patients (13.3%) in Group P, 13 patients (43.3%) in Group M1, five patients (16.6%) in Group M2 and one patient (3.3%) in Group O required a second dose of the study drug. After administration of the study drugs, nausea scores were significantly lower in all groups than before these drugs were given. No patient had a sedation score over 3 (the patients remained awake and/or responded to verbal contact). The sedative effects of midazolam and propofol lasted for a much shorter time than the antiemetic effects of these drugs.


CONCLUSIONS
Propofol and midazolam used in subhypnotic doses were as effective as ondansetron in treating PONV in patients undergoing abdominal or gynaecological surgery without untoward sedative or cardiovascular effects.
Unlugenc
H
H
Cukurova University, Faculty of Medicine, Department of Anaesthesiology, Adana, Turkey. unlugenc@cu.edu.tr
Guler
T
T
Gunes
Y
Y
Isik
G
G
D000005:Abdomen / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D000932:Antiemetics / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008297:Male; D008874:Midazolam / Q000627:therapeutic use*; D008875:Middle Aged; D017294:Ondansetron / Q000627:therapeutic use*; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy*; D015742:Propofol / Q000627:therapeutic use*
D018686:Anesthetics, Intravenous; D000932:Antiemetics; D017294:Ondansetron; D008874:Midazolam; D015742:Propofol