Ondansetron or droperidol for prophylaxis of nausea and vomiting after intrathecal morphine.
OBJECTIVE
There is a controversy regarding the best drug for prevention of nausea and vomiting in patients receiving intrathecal morphine. The aim of this study was to examine efficacy and tolerability of droperidol compared with ondansetron for the prevention of morphine-induced nausea and vomiting.


METHODS
In a randomized, placebo-controlled trial, 120 women undergoing Caesarean section under spinal anaesthesia with intrathecal morphine 0.1 mg received intravenous ondansetron 4 mg (n = 40), droperidol 1.25 mg (n = 40) or saline (n = 40) immediately after umbilical-cord clamping. Nausea and vomiting were graded according to intensity at 1, 2, 4, 6, 12 and 24 h.


RESULTS
Nausea or vomiting occurred in 14 patients (35%) in the placebo group, 4 (10%) in the ondansetron group and 10 (25%) in the droperidol group; the difference between ondansetron and placebo was statistically significant (P = 0.007). Eleven of the 14 placebo patients (27.5%) vomited, compared with none of the 4 ondansetron patients (vs. placebo, P = 0.0004) and 5 of the droperidol patients (vs. placebo, P = 0.18). Three of the 14 placebo patients (7.5%) were nauseous, compared with 4 (10%) receiving ondansetron and 5 (12.5%) receiving droperidol.


CONCLUSIONS
Ondansetron was effective in reducing the incidence of nausea and vomiting in patients receiving intrathecal morphine for Caesarean section.
Peixoto
A J
AJ
Hospital de Caridade, Department of Anaesthesiology, Erechim, Brazil. peixoto@st.com.br
Celich
M F
MF
Zardo
L
L
Peixoto Filho
A J
AJ
D000328:Adult; D002585:Cesarean Section; D004311:Double-Blind Method; D004329:Droperidol / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D007278:Injections, Spinal; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D017294:Ondansetron / Q000008:administration & dosage*; D010919:Placebos; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced / Q000517:prevention & control*; D011247:Pregnancy; D013997:Time Factors; D016896:Treatment Outcome
D010919:Placebos; D017294:Ondansetron; D009020:Morphine; D004329:Droperidol