title: Betahistine reduces postoperative nausea and vomiting after laparoscopic gynecological surgery.
abstract: Patients undergoing laparoscopic gynecological surgery are at high risk of postoperative nausea and vomiting (PONV). We compared the antiemetic efficacy of ondansetron plus betahistine with that of ondansetron alone in this patient population.
  
  
  
  In this randomized, double-blinded study, 168 patients were randomly allocated to receive placebo (O group) or betahistine 18 mg (OB group) orally 3 hours before surgery and 24 hours thereafter. In both groups, ondansetron 4 mg was administered at the end of surgery and 8 mg were added to an intravenous patient-controlled analgesia (IV-PCA) fentanyl solution. The primary outcome was complete response (no PONV and no rescue antiemetics) during the first 48 hours after surgery. The severity of nausea, pain score, and adverse events were assessed.
  
  
  
  The incidence of complete response was significantly higher in OB group than in O group (69% vs. 46%, P=0.004). The severity of nausea was lower in OB group than in O group during 30 minutes to 6 hours and 6 to 24 hours after surgery (P=0.001 and P<0.001). Pain score was similar between the groups. The incidence of dizziness was lower in OB group than in O group (13% vs. 40%, P < 0.001). Six patients (7%) in OB group and 15 patients (18%) in O group required early IV-PCA discontinuation, primarily because of PONV and/or dizziness (P=0.038).
  
  
  
  Compared to ondansetron alone, ondansetron plus betahistine was more effective to prevent PONV and dizziness in high-risk patients undergoing laparoscopic gynecological surgery.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, South Korea - koobn@yuhs.ac.
authors.forename: Jin S
authors.initials: JS
authors.lastname: Cho
authors.forename: Eun J
authors.initials: EJ
authors.lastname: Kim
authors.forename: Jae H
authors.initials: JH
authors.lastname: Lee
authors.forename: So J
authors.initials: SJ
authors.lastname: Kim
authors.forename: Jeong M
authors.initials: JM
authors.lastname: Kim
authors.forename: Jung I
authors.initials: JI
authors.lastname: Byun
authors.forename: Eun J
authors.initials: EJ
authors.lastname: Nam
authors.forename: Bon N
authors.initials: BN
authors.lastname: Koo
mesh_terms: D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000009:adverse effects / Q000627:therapeutic use*; D001621:Betahistine / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008875:Middle Aged; D017294:Ondansetron / Q000009:adverse effects / Q000627:therapeutic use*; D010147:Pain Measurement; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy*; D011446:Prospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D000932:Antiemetics; D017294:Ondansetron; D001621:Betahistine