Document Detail


A randomized comparison of a multimodal management strategy versus combination antiemetics for the prevention of postoperative nausea and vomiting.
MedLine Citation:
PMID:  15281507     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A multimodal management strategy for the prevention of postoperative nausea and vomiting (PONV) appears to be superior to single-drug prophylaxis. We tested the hypothesis that a multimodal PONV prophylaxis regimen incorporating total IV anesthesia (TIVA) with propofol and a combination of ondansetron and droperidol is more effective than a combination of these antiemetics in the presence of an inhaled anesthetic. Ninety patients undergoing laparoscopic cholecystectomy were randomized to one of three groups. Group 1 (multimodal group) received TIVA with propofol, droperidol, and ondansetron. Group 2 (combination group) received droperidol and ondansetron with isoflurane and nitrous oxide for the maintenance of anesthesia. Group 3 (TIVA group) received propofol for the induction and maintenance of anesthesia. The complete response rate (no PONV and no rescue antiemetic) at 2 h after surgery was 90%, 63%, and 66% in Groups 1, 2, and 3, respectively (P < 0.05, Group 1 versus Group 2). At 24 h, the complete response rate was 80%, 63%, and 43% in Groups 1, 2, and 3, respectively (P < 0.05, Group 1 versus Group 3). Patient satisfaction was also greater in the multimodal group than in the other two groups in the postanesthesia care unit (P < 0.05). In conclusion, the multimodal management strategy for PONV was associated with a higher complete response rate and greater patient satisfaction when compared with similar antiemetic prophylaxis with inhaled anesthesia or TIVA with propofol.
Authors:
Ashraf S Habib; William D White; Steve Eubanks; Theodore N Pappas; Tong J Gan
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  99     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-07-29     Completed Date:  2004-08-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  77-81     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina 27710, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, Intravenous / adverse effects
Anesthetics, Intravenous / adverse effects
Antiemetics / therapeutic use*
Cholecystectomy, Laparoscopic / adverse effects
Combined Modality Therapy
Double-Blind Method
Droperidol / therapeutic use
Drug Combinations
Female
Humans
Isoflurane / adverse effects
Male
Middle Aged
Nitrous Oxide / adverse effects
Ondansetron / therapeutic use
Postoperative Nausea and Vomiting / diagnosis,  prevention & control*
Propofol / adverse effects
Chemical
Reg. No./Substance:
0/Anesthetics, Intravenous; 0/Antiemetics; 0/Drug Combinations; 10024-97-2/Nitrous Oxide; 2078-54-8/Propofol; 26675-46-7/Isoflurane; 548-73-2/Droperidol; 99614-02-5/Ondansetron

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


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