title: Ondansetron has similar clinical efficacy against both nausea and vomiting.
abstract: Ondansetron is widely believed to prevent postoperative vomiting more effectively than nausea. We analysed data from 5161 patients undergoing general anaesthesia who were randomly stratified to receive a combination of six interventions, one of which was 4 mg ondansetron vs placebo. For the purpose of this study a 20% difference in the relative risks for the two outcomes was considered clinically relevant. Nausea was reduced from 38% (969/2585) in the control to 28% (715/2576) in the ondansetron group, corresponding to a relative risk of 0.74, or a relative risk reduction of 26%. Vomiting was reduced from 17% (441/2585) to 11% (293/2576), corresponding to a relative risk of 0.67, or a relative risk reduction of 33%. The relative risks of 0.67 and 0.74 were clinically similar and the difference between them did not reach statistical significance. We thus conclude that ondansetron prevents postoperative nausea and postoperative vomiting equally well.
authors.affiliation: Helsinki University Hospital, Helsinki, Finland.
authors.forename: R M
authors.initials: RM
authors.lastname: Jokela
authors.forename: O S
authors.initials: OS
authors.lastname: Cakmakkaya
authors.forename: O
authors.initials: O
authors.lastname: Danzeisen
authors.forename: K T
authors.initials: KT
authors.lastname: Korttila
authors.forename: P
authors.initials: P
authors.lastname: Kranke
authors.forename: A
authors.initials: A
authors.lastname: Malhotra
authors.forename: A
authors.initials: A
authors.lastname: Paura
authors.forename: O C
authors.initials: OC
authors.lastname: Radke
authors.forename: D I
authors.initials: DI
authors.lastname: Sessler
authors.forename: A
authors.initials: A
authors.lastname: Soikkeli
authors.forename: N
authors.initials: N
authors.lastname: Roewer
authors.forename: C C
authors.initials: CC
authors.lastname: Apfel
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D000932:Antiemetics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017294:Ondansetron / Q000627:therapeutic use*; D020250:Postoperative Nausea and Vomiting / Q000209:etiology / Q000517:prevention & control*; D011184:Postoperative Period; D012307:Risk Factors
chemical_list: D000932:Antiemetics; D017294:Ondansetron