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Antiemetic effect of ondansetron 0.2 mg mL−1 in PCA morphine solution

Published online by Cambridge University Press:  01 August 2007

P. Boonmak ,
S. Boonmak ,
P. Bunsaengjaroen ,
S. Srichaipanha ,
S. Poomsawat  and
D. Nonlhaopol
P. Boonmak*
Affiliation:
Khon Kaen University, Faculty of Medicine, Department of Anesthesiology, Khon Kaen, Thailand
S. Boonmak
Affiliation:
Khon Kaen University, Faculty of Medicine, Department of Anesthesiology, Khon Kaen, Thailand
P. Bunsaengjaroen
Affiliation:
Khon Kaen University, Faculty of Medicine, Department of Anesthesiology, Khon Kaen, Thailand
S. Srichaipanha
Affiliation:
Khon Kaen University, Faculty of Medicine, Department of Anesthesiology, Khon Kaen, Thailand
S. Poomsawat
Affiliation:
Khon Kaen University, Faculty of Medicine, Department of Anesthesiology, Khon Kaen, Thailand
D. Nonlhaopol
Affiliation:
Khon Kaen University, Faculty of Medicine, Department of Anesthesiology, Khon Kaen, Thailand
*
Correspondence to: Polpun Boonmak, Anesthesiology Department, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand. E-mail: polpun@hotmail.com; Tel: +66 043 348390; Fax: +66 043 348390
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Summary

Background and objectives

To study the effect of 0.2 mg mL−1 of ondansetron added to morphine patient-controlled analgesia solution after a 4 mg loading dose on the incidence and severity of postoperative nausea and vomiting.

Methods

One hundred and sixty patients scheduled for elective surgery, between 18 and 65 yr old, were studied. Patients who smoked, received antiemetics and hormonal therapy, had a history of motion sickness or gastrointestinal disease, a body mass index >35 or menstruation at the time of the study were excluded. Patients were assigned to the ondansetron and control groups by block randomization. At the end of anaesthesia, all patients received 4 mg of ondansetron intravenously and the same patient-controlled analgesia regimen of morphine. The ondansetron group (n = 80) received 0.2 mg of ondansetron per 1 mg of morphine. The nausea score, vomiting score and the requested ondansetron dose were evaluated at 1, 2, 6, 12 and 24 h. Patient-satisfaction for nausea/vomiting was recorded at the end of the study.

Results

Patient characteristics and cumulative morphine consumption were similar but ondansetron group had higher pain scores (P = 0.006). The ondansetron group had a lower nausea and vomiting scores, and more patients were free from nausea and vomiting than the control group (41 vs. 26, respectively, P = 0.025). The ondansetron group had fewer cumulative ondansetron doses than the control group and better patient satisfaction than the control group (P < 0.05).

Conclusion(s)

Ondansetron 4 mg plus 0.2 mg mL−1 given with PCA morphine can reduce nausea and vomiting thus improving patient satisfaction.

Keywords

POSTOPERATIVE NAUSEA AND VOMITINGONDANSETRONANALGESIAPATIENT CONTROLLEDMORPHINE
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 8 , August 2007 , pp. 664 - 667
Copyright
Copyright © European Society of Anaesthesiology 2007

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References

1.Walder, B, Schafer, M, Henzi, I, Tramer, MR. Efficacy and safety of patient-controlled opioid analgesia for acute postoperative pain. A quantitative systematic review. Acta Anaesthesiol Scand 2001; 45: 795–804.CrossRefGoogle ScholarPubMed
2.Tramer, MR, Walder, B. Efficacy and adverse effects of prophylactic antiemetics during patient-controlled analgesia therapy: a quantitative systematic review. Anesth Analg 1999; 88: 1354–1361.CrossRefGoogle ScholarPubMed
3.Hill, RP, Lubarsky, DA, Phillips-Bute, B et al. . Cost-effectiveness of prophylactic antiemetic therapy with ondansetron, droperidol, or placebo. Anesthesiology 2000; 92: 958–967.CrossRefGoogle ScholarPubMed
4.Apfel, CC, Korttila, K, Abdalla, M et al. . A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. N Engl J Med 2004; 350: 2441–2451.CrossRefGoogle ScholarPubMed
5.Tang, J, Wang, B, White, PF, Watcha, MF, Qi, J, Wender, RH. The effect of timing of ondansetron administration on its efficacy, cost-effectiveness, and cost-benefit as a prophylactic antiemetic in the ambulatory setting. Anesth Analg 1998; 86: 274–282.CrossRefGoogle ScholarPubMed
6.Munro, FJ, Fisher, S, Dickson, U, Morton, N. The addition of antiemetics to the morphine solution in patient controlled analgesia syringes used by children after an appendectomy does not reduce the incidence of postoperative nausea and vomiting. Paediatr Anaesth 2002; 12: 600–603.CrossRefGoogle Scholar
7.Dresner, M, Dean, S, Lumb, A, Bellamy, M. High-dose ondansetron regimen vs droperidol for morphine patient-controlled analgesia. Br J Anaesth 1998; 81: 384–386.CrossRefGoogle ScholarPubMed
8.Habib, AS, Gan, TJ. Evidence-based management of postoperative nausea and vomiting: a review. Can J Anaesth 2004; 51: 326–341.CrossRefGoogle ScholarPubMed
9.Biedler, A, Wermelt, J, Kunitz, O et al. . A risk adapted approach reduces the overall institutional incidence of postoperative nausea and vomiting. Can J Anaesth 2004; 51: 13–19.CrossRefGoogle ScholarPubMed
10.Sanansilp, V, Soontarinka, S, Kantigal, P et al. . Adding droperidol to morphine patient-controlled analgesia: effect on nausea and vomiting. J Med Assoc Thai 2002; 85: S923–S933.Google ScholarPubMed
11.Alexander, R, Lovell, AT, Seingry, D, Jones, RM. Comparison of ondansetron and droperidol in reducing postoperative nausea and vomiting associated with patient-controlled analgesia. Anaesthesia 1995; 50: 1086–1088.CrossRefGoogle ScholarPubMed
12.White, PF, Watcha, MF. Postoperative nausea and vomiting: prophylaxis versus treatment. Anesth Analg 1999; 89: 1337–1339.CrossRefGoogle ScholarPubMed
13.Fisher, DM. Surrogate outcomes: meaningful not! Anesthesiology 1999; 90: 355–356.CrossRefGoogle ScholarPubMed
14.Cherian, VT, Smith, I. Prophylactic ondansetron does not improve patient satisfaction in women using PCA after Caesarean section. Br J Anaesth 2001; 87: 502–504.CrossRefGoogle Scholar