Prophylactic Diclectin reduces the incidence of postoperative vomiting.
BACKGROUND
Diclectin(R) (DCL) is an effective antiemetic used for relief of nausea and vomiting in pregnancy. It is unknown whether DCL is effective in the prevention of postoperative nausea and vomiting (PONV).


METHODS
We conducted a randomized, stratified, double-blind placebo-controlled trial to examine the incidence of PONV in women undergoing elective laparoscopic tubal ligation in the day surgery setting. DCL (doxylamine succinate 10 mg and pyridoxine hydrochloride 10 mg) was administered orally the night before surgery, the morning of surgery, and upon hospital discharge.


RESULTS
We enrolled 146 women in the trial, 127 of whom were included in the effectiveness analysis and 102 of whom were included in the efficacy analysis. We did not detect a difference in the incidence of nausea and vomiting in the first six hours postoperatively after adjusting for additional antiemetics administered. Patients receiving DCL as compared with placebo were significantly less likely to experience vomiting six to 24 hr postoperatively [5/59 (8.5%) vs 14/55 (25.4%), P < 0.017]. Treated patients tended to return to work earlier than those who received placebo (1.74 vs 3.7 days P = NS).


CONCLUSIONS
Perioperative oral DCL reduces the incidence of postoperative vomiting in women undergoing elective laparoscopic tubal ligation, and may accelerate return to work.
Reeve
Brenda K
BK
Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada. acescholes@yahoo.com <acescholes@yahoo.com>
Cook
Deborah J
DJ
Babineau
Denise
D
Scholes
L Cory
LC
Buckley
D Norman
DN
D000328:Adult; D000556:Ambulatory Surgical Procedures; D000932:Antiemetics / Q000627:therapeutic use*; D004025:Dicyclomine; D004311:Double-Blind Method; D004319:Doxylamine / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D010535:Laparoscopy; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology / Q000517:prevention & control*; D011736:Pyridoxine / Q000627:therapeutic use*; D018401:Sample Size; D013246:Sterilization, Tubal; D016896:Treatment Outcome
D000932:Antiemetics; D004338:Drug Combinations; C004454:dicyclomine, doxylamine, pyridoxine drug combination; D004025:Dicyclomine; D004319:Doxylamine; D011736:Pyridoxine