Document Detail

Oral ondansetron, tropisetron or metoclopramide to prevent postoperative nausea and vomiting: a comparison in high-risk patients undergoing thyroid or parathyroid surgery.
MedLine Citation:
PMID:  12027845     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Oral antiemetic prophylaxis may be a practical alternative to intravenous administration. Intravenous ondansetron and tropisetron prevent postoperative nausea and vomiting (PONV) at least as efficiently as traditional antiemetics, droperidol and metoclopramide. We tested the hypothesis that the incidence of PONV after oral ondansetron or tropisetron prophylaxis is lower compared with metoclopramide among high-risk patients. METHODS: In a prospective, double-blind study we studied 179 high-risk patients who received either ondansetron 16 mg, tropisetron 5 mg, or metoclopramide 10 mg orally 1 h before the operation. A standard general anesthetic technique and postoperative analgesia were used. The incidence of PONV and the need for rescue antiemetic medication was recorded for 24 h. RESULTS: In the postanesthesia care unit, the incidence of PONV was lower after premedication with tropisetron compared with ondansetron and metoclopramide (15%, 32% and 39%, respectively). The incidence of PONV during 0-24 h was the same in each group (68%, 58% and 75% in the ondansetron, tropisetron and metoclopramide group, respectively), but the incidence of vomiting was significantly lower after ondansetron (34%) and tropisetron (22%) prophylaxis compared with metoclopramide (53%). The need for additional antiemetics was significantly lower after tropisetron prophylaxis compared with metoclopramide. Patient satisfaction was significantly higher after tropisetron than after metoclopramide. CONCLUSIONS: In the initial period, the incidence of PONV was lower after premedication with oral tropisetron than after ondansetron or metoclopramide. Considering the entire 24-h postoperative period, the incidence of PONV was the same after all three premedications, but the incidence of vomiting was lower after oral ondansetron and tropisetron than after metoclopramide.
R Jokela; M Koivuranta; T Kangas-Saarela; S Purhonen; S Alahuhta
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  46     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-24     Completed Date:  2002-07-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  519-24     Citation Subset:  IM    
Department of Anesthesia and Intensive Care, Helsinki University, Helsinki, Finland.
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MeSH Terms
Analgesics, Opioid / therapeutic use
Antiemetics / therapeutic use*
Double-Blind Method
Indoles / therapeutic use*
Metoclopramide / therapeutic use*
Ondansetron / therapeutic use*
Oxycodone / therapeutic use
Pain, Postoperative / complications,  drug therapy
Parathyroid Glands / surgery*
Postoperative Nausea and Vomiting / prevention & control*
Prospective Studies
Thyroid Gland / surgery*
Reg. No./Substance:
0/Analgesics, Opioid; 0/Antiemetics; 0/Indoles; 364-62-5/Metoclopramide; 76-42-6/Oxycodone; 89565-68-4/tropisetron; 99614-02-5/Ondansetron

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