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Comparative study of the antiemetic efficacy of ondansetron, propofol and midazolam in the early postoperative period

Published online by Cambridge University Press:  23 December 2004

H. Unlugenc ,
T. Guler ,
Y. Gunes  and
G. Isik
H. Unlugenc
Affiliation:
Cukurova University, Faculty of Medicine, Department of Anaesthesiology, Adana, Turkey
T. Guler
Affiliation:
Cukurova University, Faculty of Medicine, Department of Anaesthesiology, Adana, Turkey
Y. Gunes
Affiliation:
Cukurova University, Faculty of Medicine, Department of Anaesthesiology, Adana, Turkey
G. Isik
Affiliation:
Cukurova University, Faculty of Medicine, Department of Anaesthesiology, Adana, Turkey
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Extract

Summary

Background and objective: To compare the antiemetic efficacy of ondansetron with two different hypnotic drugs (propofol 15 mg, midazolam 1 and 2 mg) for the treatment of established postoperative nausea and vomiting (PONV).

Methods: Four-hundred-and-fifty-three patients scheduled for elective gynaecological or abdominal surgery were enrolled. One-hundred-and-twenty patients (26%) experienced postoperative emesis, and when nausea scores reached 2 or greater on a five-point scale, they were randomized to receive intravenously: propofol 15 mg (1.5 mL) in Group P, midazolam 1 mg in Group M1, midazolam 2 mg in Group M2 and ondansetron 4 mg in Group O.

Results: Four patients (13.3%) in Group P, 13 patients (43.3%) in Group M1, five patients (16.6%) in Group M2 and one patient (3.3%) in Group O required a second dose of the study drug. After administration of the study drugs, nausea scores were significantly lower in all groups than before these drugs were given. No patient had a sedation score over 3 (the patients remained awake and/or responded to verbal contact). The sedative effects of midazolam and propofol lasted for a much shorter time than the antiemetic effects of these drugs.

Conclusions: Propofol and midazolam used in subhypnotic doses were as effective as ondansetron in treating PONV in patients undergoing abdominal or gynaecological surgery without untoward sedative or cardiovascular effects.

Keywords

ANAESTHETICS, INTRAVENOUS, propofolANTIEMETICS, ondansetronBENZODIAZEPINES, midazolamPOSTOPERATIVE COMPLICATIONS, postoperative nausea and vomiting
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 1 , January 2004 , pp. 60 - 65
Copyright
2004 European Society of Anaesthesiology

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