Prophylactic antiemetic therapy for acute abdominal surgery. A comparative study of droperidol, metoclopramide, tropisetron, granisetron and dexamethasone.
OBJECTIVE
It is calculated that the incidence of postoperative nausea and vomiting (PONV) is approximately 30%. The prophylaxis of PONV has been the subject of several studies, both to decrease this problem and to compare the cost-benefit ration of the treatment used. The objective of this study was to compare the efficacy of 5 antiemetic drugs with a control group in emergency appendectomy.


METHODS
A controlled, double-blind, prospective study with 150 patients, ASA I and II, BMI < 30, undergoing appendectomy, was undertaken. Patients were divided in six groups: Group 1 (n = 25): 5 mL of normal saline; Group 2 (n = 25): 0.625 mg of droperidol; Group 3 (n = 25): 20 mg of metoclopramide; Group 4 (n = 25): 5 mg of tropisetron; Group 5 (n = 25): 1 mg of granisetron; Group 6 (n = 25): 4 mg of dexamethasone. Monitoring included ECG non-invasive blood pressure, O2 saturation, P(ET)CO2, anesthetic gas analyzer and peripheral nerve stimulator. The presence of PONV complications and the degree of satisfaction in the first 48 hours were evaluated.


RESULTS
The incidence of PONV in the droperidol group was 4% while in the granisetron, tropisetron and metoclopramide groups it was 12% (p < 0.05). The dexamethasone group had a 24% incidence and the control group 28%.


CONCLUSIONS
Low doses of droperidol were more effective in the prophylaxis of PONV in emergency appendectomy than the other drugs.
Serviço de Urgências, Hospital Clínico Regional de Concepción, Universidade de Concepción, Concepción, Chile. viccontredom@yahoo.com
Víctor
V
Contreras-Domínguez
Paulina
P
Carbonell-Bellolio
D000005:Abdomen / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000627:therapeutic use*; D003907:Dexamethasone / Q000627:therapeutic use; D004311:Double-Blind Method; D004329:Droperidol / Q000627:therapeutic use; D005260:Female; D017829:Granisetron / Q000627:therapeutic use; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D008297:Male; D008787:Metoclopramide / Q000627:therapeutic use; D008875:Middle Aged; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011446:Prospective Studies; D000077526:Tropisetron; D055815:Young Adult
D000932:Antiemetics; D003907:Dexamethasone; D004329:Droperidol; D017829:Granisetron; D007211:Indoles; D008787:Metoclopramide; D000077526:Tropisetron