Document Detail


Postoperative nausea and vomiting in patients undergoing total abdominal hysterectomy under spinal anaesthesia: a randomized study of ondansetron prophylaxis.
MedLine Citation:
PMID:  16045138     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: Patients undergoing total abdominal hysterectomy under general anaesthesia have a high risk of developing postoperative nausea and vomiting (PONV). The aim of this study was to evaluate the incidence of PONV in patients undergoing total abdominal hysterectomy under spinal anaesthesia with intravenous patient-controlled analgesia (PCA) using morphine and to compare its incidence with and without antiemetic prophylaxis. METHODS: Thirty-four patients undergoing total abdominal hysterectomy under spinal anaesthesia with i.v. PCA morphine postoperatively were divided into two groups. The first (n = 17) received ondansetron prophylaxis near the end of surgery while the second (n = 17) received no prophylaxis. Morphine consumption, emetic episodes (on a 3-point scale), patient satisfaction (visual analogue score), sedation and pruritus were evaluated 2, 4, 6, 9, 12, 18 and 24h postoperatively. RESULTS: Patient characteristics, postoperative morphine consumption (43.3 +/- 7.6 vs. 40.3 +/- 12.3 mg) and peristaltic recovery time (16.9 +/- 5 vs. 18.4 +/- 5.2 h) were similar in both groups. Overall nausea and vomiting were significantly lower in the ondansetron prophylaxis group than in the group without prophylaxis (52.9% vs. 88.2%, P < 0.05). Though nausea alone was higher in the prophylaxis group (41.2% vs. 29.4%), nausea with vomiting was significantly lower in the prophylaxis group (11.8% vs. 58.8%, P < 0.01). Patients' satisfaction scores were higher in the ondansetron group at all times and the difference was significant (P < 0.05) 4 h postoperatively. CONCLUSIONS: The incidence of PONV in patients undergoing total abdominal hysterectomy under spinal anaesthesia with i.v. PCA morphine is very high (88.2%). Antiemetic prophylaxis with ondansetron is highly recommended in this patients group resulting in a lower incidence of nausea and vomiting, and significantly improves patient' satisfaction and life quality in the early postoperative period.
Authors:
E Kontrimaviciute; A Baublys; J Ivaskevicius
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  22     ISSN:  0265-0215     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-27     Completed Date:  2005-09-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  504-9     Citation Subset:  IM    
Affiliation:
Vilnius University, Anesthesiology and Intensive Care Clinic, Vilnius University Hospital, Santariskiu Klinikos, Vilnius, Lithuania. eglekon@delfi.lt
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MeSH Terms
Descriptor/Qualifier:
Analgesia, Patient-Controlled
Anesthesia, Spinal*
Antiemetics / therapeutic use*
Female
Hemodynamics / drug effects
Humans
Hysterectomy*
Middle Aged
Nausea / chemically induced,  epidemiology
Ondansetron / therapeutic use*
Pain Measurement
Patient Satisfaction
Postoperative Nausea and Vomiting / epidemiology,  prevention & control*
Prospective Studies
Vomiting / chemically induced,  epidemiology
Chemical
Reg. No./Substance:
0/Antiemetics; 99614-02-5/Ondansetron

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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