Efficacy and costs of 3 anesthetic regimens in the prevention of postoperative nausea and vomiting.
OBJECTIVE
The aim of the study was to compare the antiemetic efficacy and costs associated with 3 different anesthesia regimens used in gynecologic laparoscopy.


METHODS
This was a randomized, controlled study.


METHODS
The study was conducted at a university hospital.


METHODS
We studied 150 ASA physical status I or II patients, undergoing elective gynecologic laparoscopy with general anesthesia.


METHODS
Patients were allocated into the following 3 groups: group P-preoperative placebo tablet, propofol induction, propofol-air/O2 maintenance; group I + O-preoperative 8-mg ondansetron tablet, thiopental induction, isoflurane-N2O maintenance; group I (control)-preoperative placebo tablet, thiopental induction, isoflurane-N2O maintenance.


METHODS
The frequency of postoperative nausea and vomiting (PONV), number needed to treat to prevent PONV, and the costs of the anesthetic drugs to prevent PONV in one additional patient were evaluated.


RESULTS
The frequency of PONV within the 24-hour study period was lowest in group I + O (P, 38%; I + O, 33%; and I, 59%; P < 0.05 I + O vs I). The number needed to treat was 5 in group P and 4 in group I + O, compared with group I. The median costs of anesthetic drugs to prevent PONV in one additional patient were $65 in group P and dollar 68 in group I + O, compared with group I.


CONCLUSIONS
We conclude that in gynecologic laparoscopy, propofol-air/O2 anesthesia alone, and isoflurane-N2O anesthesia combined with an oral 8-mg dose of ondansetron had similar efficacy and costs to prevent PONV. Isoflurane-N2O anesthesia without ondansetron was less expensive, but was also less efficacious.
Purhonen
Sinikka
S
Department of Anesthesiology and Intensive Care, University Hospital of Kuopio, PO Box 1777, FIN-70211 Kuopio, Finland. sinikka.purhonen@kuh.fi
Koski
Erkki M J
EM
Niskanen
Minna
M
Hynynen
Markku
M
D000328:Adult; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000191:economics*; D018685:Anesthetics, Inhalation / Q000191:economics*; D018686:Anesthetics, Intravenous / Q000191:economics*; D000932:Antiemetics / Q000008:administration & dosage / Q000191:economics*; D004311:Double-Blind Method; D016527:Drug Costs; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007530:Isoflurane / Q000191:economics; D010535:Laparoscopy; D009609:Nitrous Oxide / Q000191:economics; D017294:Ondansetron / Q000008:administration & dosage / Q000191:economics*; D020250:Postoperative Nausea and Vomiting / Q000191:economics / Q000517:prevention & control*; D015742:Propofol / Q000191:economics; D016037:Single-Blind Method; D013874:Thiopental / Q000191:economics
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000932:Antiemetics; D017294:Ondansetron; D007530:Isoflurane; D013874:Thiopental; D009609:Nitrous Oxide; D015742:Propofol