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Placebo-controlled comparison of dolasetron and metoclopramide in preventing postoperative nausea and vomiting in patients undergoing hysterectomy

Published online by Cambridge University Press:  16 August 2006

S. N. Piper
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, Hospital of the City Ludwigshafen, D-67063 Ludwigshafen, Germany
J. G. Triem
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, Hospital of the City Ludwigshafen, D-67063 Ludwigshafen, Germany
W. H. Maleck
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, Hospital of the City Ludwigshafen, D-67063 Ludwigshafen, Germany
M. T. Fent
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, Hospital of the City Ludwigshafen, D-67063 Ludwigshafen, Germany
I. Hüttner
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, Hospital of the City Ludwigshafen, D-67063 Ludwigshafen, Germany
J. Boldt
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, Hospital of the City Ludwigshafen, D-67063 Ludwigshafen, Germany
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Abstract

Background and objective In a randomized, placebo-controlled, double-blind trial, we compared the efficacy of dolasetron and metoclopramide in preventing postoperative nausea and vomiting in women undergoing hysterectomy.

Methods Patients were allocated randomly to one of three groups: group A (n =50) received 50 mg dolasetron orally, group B (n =50) received 20 mg metoclopramide intravenously and placebo orally, group C (n =50) received placebo orally. If patients complained of retching or vomiting, or if patients demanded an antiemetic, 1.25 mg droperidol was administrated intravenously. To quantify postoperative nausea and vomiting the following score was used: 0 =no nausea, 1 =nausea, 2 =retching, 3 =single vomiting, 4 =multiple vomiting. The Raatz test was used to analyse postoperative nausea and vomiting (PONV) scores.

Results Dolasetron reduced the postoperative nausea and vomiting score significantly (P <0.02 vs. metoclopramide; P <0.0001 vs. placebo). Metoclopramide also reduced the postoperative nausea and vomiting score (P <0.02 vs. placebo). Fisher's exact test showed a significant reduction of vomiting in the dolasetron group compared with metoclo-pramide-treated patients (P <0.007) and placebo-treated patients (P <0.000006) and a significantly lower rate of nausea in comparison to the placebo group (P <0.009). There were no significant differences between the metoclopramide and the placebo groups (in Fisher's exact test). The use of postoperative droperidol per patient was significantly lower in the dolasetron group (P <0.04 vs. metoclopramide; P <0.0001 vs. placebo) than in the metoclopramide (P <0.02 vs. placebo) and in the placebo groups.

Conclusions Oral dolasetron is more effective than either metoclopramide given intravenously or placebo for preventing vomiting after hysterectomy. It also was significantly superior to either metoclopramide or placebo concerning the PONV score and the need for droperidol rescue.

Type
Original Article
Copyright
2001 European Society of Anaesthesiology

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