Journal ArticleDOI
The effect of timing of ondansetron administration in outpatients undergoing otolaryngologic surgery
TLDR
Ondansetron (4 mg IV) was more effective in reducing the need for rescue antiemetics in the recovery room when administered at the end versus prior to the start of otolaryngologic surgery.Abstract:
A randomized, double-blind, placebo-controlled study was designed to compare the relative efficacy of prophylactic ondansetron, 4 mg intravenously (IV), when administered before induction of anesthesia or at the end of surgery to an outpatient population at high risk of developing postoperative nausea and vomiting (PONV). Patients undergoing otolaryngologic surgery were randomly assigned to one of three different treatment groups: Group 1 (placebo) received saline 5 mL prior to induction of anesthesia and again at the end of surgery; Group II received ondansetron 4 mg in 5 mL prior to induction of anesthesia and saline 5 mL at the end of surgery; and Group III received saline 5 mL prior to induction of anesthesia and ondansetron 4 mg at the end of surgery. All patients received the same general anesthetic technique. A standardized regimen of rescue antiemetics was administered in the recovery room to patients with > or = 2 emetic episodes or at the patients request for persistent nausea. Episodes of nausea and vomiting, as well as the need for rescue antiemetics, were recorded for 24 h after the operation. The incidences of nausea and emesis in the recovery room after prophylactic ondansetron, 4 mg IV, administered either before induction (68% and 20%, respectively) or at the end of surgery (60% and 4%, respectively) were not significantly decreased compared to the placebo control group (80% and 12%, respectively). However, when ondansetron was administered at the end of the operation, it significantly reduced the need for rescue antiemetics in the recovery room (36% vs 64% in the control group). The postanesthesia care unit and hospital discharge times were similar in all three study groups. One patients in Group II and one patient in Group III were hospitalized because of intractable symptoms related to PONV. After discharge from the ambulatory surgery unit, the incidence of nausea, vomiting, and the need for rescue antiemetic drugs were similar in all three treatment groups. In conclusion, ondansetron (4 mg IV) was more effective in reducing the need for rescue antiemetics in the recovery room when administered at the end versus prior to the start of otolaryngologic surgery. Therefore, when ondansetron is used for antiemetic prophylaxis in outpatients undergoing otolaryngologic procedures, it should be administered at the end of the operation rather than prior to induction of anesthesia.read more
Citations
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Journal ArticleDOI
Consensus Guidelines for the Management of Postoperative Nausea and Vomiting
Tong J. Gan,Pierre Diemunsch,Ashraf S. Habib,Anthony L. Kovac,Peter Kranke,Tricia A. Meyer,Mehernoor F. Watcha,Frances Chung,Shane Angus,Christian C. Apfel,Sergio D. Bergese,Keith A. Candiotti,Matthew T. V. Chan,Peter J. Davis,Vallire D. Hooper,Sandhya Lagoo-Deenadayalan,Paul S. Myles,Greg Nezat,Beverly K. Philip,Martin R. Tramèr +19 more
TL;DR: The present guidelines are the most recent data on postoperative nausea and vomiting (PONV) and an update on the 2 previous sets of guidelines published in 2003 and 2007.
Journal ArticleDOI
Consensus guidelines for managing postoperative nausea and vomiting.
Tong J. Gan,Tricia A. Meyer,Christian C. Apfel,Frances Chung,Peter J. Davis,Steve Eubanks,Anthony L. Kovac,Beverly K. Philip,Daniel I. Sessler,James Temo,Martin R. Tramèr,Mehernoor F. Watcha +11 more
TL;DR: Evidence-based guidelines developed by an international panel of experts for the management of postoperative nausea and vomiting are presented.
Journal ArticleDOI
Society for Ambulatory Anesthesia guidelines for the management of postoperative nausea and vomiting.
Tong J. Gan,Tricia A. Meyer,Christian C. Apfel,Frances Chung,Peter J. Davis,Ashraf S. Habib,Vallire D. Hooper,Anthony L. Kovac,Peter Kranke,Paul S. Myles,Beverly K. Philip,Gregory P. Samsa,Daniel I. Sessler,James Temo,Martin R. Tramèr,Craig A. Vander Kolk,Mehernoor F. Watcha +16 more
TL;DR: These guidelines identify risk factors for PonV in adults and children; recommend approaches for reducing baseline risks for PONV; identify the most effective antiemetic monotherapy and combination therapy regimens for P ONV prophylaxis; recommend approach for treatment of PONv when it occurs; and provide an algorithm for the management of individuals at increased risk for POnV.
Journal ArticleDOI
Prevention and Treatment of Postoperative Nausea and Vomiting
TL;DR: This multimodal PONV management approach includes use of multiple different antiemetics medications (double or triple combination antiemetic therapy acting at different neuroreceptor sites); less emetogenic anaesthesia techniques; adequate intravenous hydration; and adequate pain control.
Journal ArticleDOI
Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting.
Tong J. Gan,Kumar G. Belani,Sergio D. Bergese,Frances Chung,Pierre Diemunsch,Ashraf S. Habib,Zhaosheng Jin,Anthony L. Kovac,Tricia A. Meyer,Richard D. Urman,Christian C. Apfel,Sabry Ayad,Linda Beagley,Keith A. Candiotti,Marina Englesakis,Traci L. Hedrick,Peter Kranke,Samuel Lee,Daniel Lipman,Harold S. Minkowitz,John Morton,Beverly K. Philip +21 more
TL;DR: This consensus statement presents a comprehensive and evidence-based set of guidelines for the care of postoperative nausea and vomiting (PONV) in both adult and pediatric populations based on a comprehensive search and review of literature up to September 2019.
References
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Journal ArticleDOI
Postoperative nausea and vomiting. Its etiology, treatment, and prevention.
TL;DR: Patients at high risk for postoperative emesis should receive special considerations with respect to the prophylactic use of antiemetic drugs, as suggested in a recent editorial.
Journal ArticleDOI
Surgical and patient factors involved in postoperative nausea and vomiting.
TL;DR: Before this report, anaesthetics alone were thought to be responsible for most postoperative nausea and vomiting (PONV), but now it is thought that opioids alone are responsible for some postoperative vomiting.
Journal ArticleDOI
Comparison of Ondansetron Versus Placebo to Prevent Postoperative Nausea and Vomiting in Women Undergoing Ambulatory Gynecologic Surgery
Ray McKenzie,Anthony L. Kovac,Thomas A. O’Connor,D. Duncalf,John J. Angel,I Gratz,Eugene Tolpin,Charles H. McLeskey,Alan Joslyn +8 more
TL;DR: Ondansetron given intravenously to prevent postoperative nausea and emesis was highly effective in the 4− and 8-mg doses in women having ambulatory gynecologic surgery.
Journal ArticleDOI
A comparison of costs and efficacy of ondansetron and droperidol as prophylactic antiemetic therapy for elective outpatient gynecologic procedures.
TL;DR: It is concluded that droperidol 0.625 mg IV provides antiemetic prophylaxis comparable to that of ondansetron 4 mg IV without increasing side effects or delaying discharge and is more cost-effective.
Journal ArticleDOI
Single dose intravenous ondansetron in the prevention of postoperative nausea and vomiting
TL;DR: Intravenous ondansetron is safe and effective at preventing postoperative nausea and vomiting in male and female patients undergoing day case surgery.