The Antiemetic Efficacy of Prophylactic Ondansetron and Droperidol in Epidural Anesthesia / 대한마취과학회지

BACKGROUND: Ondansetron, a 5-HT3 (hydroxytryptamine receptor 3) receptor antagonist, is effective for prevention and treatment of postoperative nausea and vomiting. This study is to evaluate the intraoperative and postoperative efficacy of prophylactic ondansetron and droperidol in preventing nausea and vomiting in cesarean section patients under epidural anesthesia. METHODS: Sixty ASA physical status I-II parturients undergoing elective cesarean section under epidural anesthesia were allocated to 3 groups received intravenous ondansetron 4 mg (Group O), droperidol 1.25 mg (Group D) and normal saline 1 ml (Group N) after delivery of baby. The intra and postoperative incidence and severity of nausea and vomiting were recorded using 4 point scale (0: none, 1 : mild, 2: moderate, 3: severe). RESULTS: There were significantly lower incidence and severity of nausea and vomiting in Group O and Group D than in Group N during intra and postoperative 24 hours (p<0.05). CONCLUSIONS: Prophylactic ondansetron and droperidol had antiemetic effect in cesarean section patients under epidural anesthesia and these effect was observed long after the normal expected duration.

A Comparison of the Efficacy and Safety of Ondansetron, Droperidol and Ondansetron Plus Droperidol as Antiemetics for Elective Thyroidectomy / 대한마취과학회지

BACKGROUND: Thyroidectomy has been a surgical procedure associated with a high incidence of postoperative nausea and vomiting (PONV), and conventional antiemetics cannot prevent PONV effectively. In this study, we compared the efficacy and safety of ondansetron 70 microgram/kg, droperidol 10 microgram/kg and combination of both drugs to placebo in the prevention of PONV. METHODS: Seventy-six patients undergoing thyroidectomy were randomized to receive placebo (Group I, n=20), ondansetron 70 microgram/kg (Group II, n=19), droperidol 10 microgram/kg (Group III, n=18) and combination of both drugs (Group IV, n=19). The effects of these regimens on the incidence and severity of PONV and adverse events were analyzed for the 0 to 1 hour and 1 to 24 hours postoperative periods. RESULTS: In the 0 to 1 hour postoperative periods, the incidence of symptom free (no nausea and retching or vomiting) paients were 60% for placebo, 68.4% for ondansetron (p>0.05 versus placebo group), 88.9% for droperidol (p0.05 versus placebo group), 77.8% for droperidol (p0.05 versus placebo group), 77.8% for droperidol (p<0.05 versus placebo and ondansetron group), and 73.7% for combination of both drugs (p<0.05 versus placebo and ondansetron group). Also, there were no significant differences between the droperidol and droperidol plus ondansetron group. Among the side effects associated with antiemetics, headache and dizziness incidence was higher. CONCLUSIONS: Droperidol and combination of ondansetron plus droperidol was superior to placebo, and ondansetron for prevention of PONV during the first 24 hours postoperative period.

Dexamethasone Administration and Propofol Anesthesia Prevent Postoperative Nausea and Vomiting / 대한마취과학회지

BACKGROUND: Nausea, vomiting are among the most common postoperative complaints. We compared the effects of dexamethasone with or without propofol to the effects of conventional regimen consisting of enflurane-N2O in the prevention of postoperative nausea and vomiting. METHODS: Eighty healthy children, aged 3~14 yr, undergoing elective tonsillectomy were alldegrees Cated randomly to receive either 67% nitrous oxide and 1.5~2.0% enflurane or 67% nitrous oxide and propofol infusion 6~10 mg/kg/hr for maintenance of anesthesia. Dexamethasone 150 microgram/kg(maximum dose 8mg) or placebo was administered intrvenously(IV) in a double-blinded fashion before surgery. RESULTS: Dexamethasone reduced the overall incidence of vomiting from 45%(control) to 10%, Propofol also reduced from 45% to 15%. Combination of propofol anesthesia and dexamethasone administration reduced from 45% to 10%. CONCLUSIONS: Dexamethasone and propofol markedly decreased vomiting in healthy children after elective tonsillectomy.