Nicotine patch for the prevention of postoperative nausea and vomiting: a prospective randomised trial.
OBJECTIVE
It has been demonstrated that smoking significantly reduces postoperative nausea and vomiting (PONV). However, there are approximately 4000 substances in cigarette smoke that can be responsible for this effect. To demonstrate whether nicotine is the substance with antiemetic effects we applied a nicotine patch in patients undergoing laparoscopic cholecystectomy under general anaesthesia.


METHODS
Seventy-five patients classified as ASA (American Society of Anesthesiologists' classification) I/II were divided in three groups: group 1 (n = 25), which comprised non-smokers; group 2 (n = 25), which comprised patients who had given up smoking for the last 5 years and received perioperatively a nicotine patch that contained 16.6mg nicotine/patch; and group 3 (n = 25), which comprised actual smokers. Postoperatively, the incidence of PONV and the need for antiemetic rescue medication were monitored every 6 hours.


RESULTS
We found a significant reduction in the incidence of PONV in group 2 (5/25 [20%], p = 0.0001 vs group 1) and group 3 (8/25 [32%], p = 0.002 vs group 1) compared with group 1 (18/25 [76%]). The difference in incidence of PONV between group 2 and group 3 was not significant (p > 0.05).


CONCLUSIONS
Nicotine significantly reduced the incidence of PONV after laparoscopic cholecystectomy.
Ionescu
Daniela
D
Department of Anesthesia and Intensive Care, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Japoca, Romania. dionescuati@yahoo.com
Badescu
Cristina
C
Acalovschi
Iurie
I
D000279:Administration, Cutaneous; D000932:Antiemetics / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011446:Prospective Studies; D012907:Smoking
D000932:Antiemetics; D009538:Nicotine