Related Experiment Videos
[Postoperative vomiting]
László Vimláti1, Júlia Pallós, Katalin Nagy
1Egészségtudományi Kar, Aneszteziológiai és Intenzív Terápiás Klinika, Semmelweis Egyetem, Budapest.
Introduction:
Nausea and vomiting following general anaesthesia are among the most frequent adverse reactions causing complications, the relief of which is an absolute demand. 5-HT3 receptor antagonists, such as ondansetron, belonging to the latest class of antiemetics were launched more than a decade ago.
Patients/Methods:
Efficacy and tolerability of ondansetron injection in prevention of postoperative nausea and vomiting were investigated in a prospective, randomised, double-blind, placebo controlled, three-armed clinical study in 148 patients undergoing laparoscopic cholecystectomy. Moreover the authors also investigated the effect of timing of dosing, i.e. whether the administration of antiemetic drug before starting anaesthesia has any advantage comparing its use at the end of operation.
Results:
While using a standard surgical and anaesthesia method vomiting after laparoscopic cholecystectomy occurred in a frequency of 44.7% of the patients in the placebo group, whereas the figures decreased significantly after administration of 4 mg ondansetron at the end (28.9%) or before (25.5%) anaesthesia. Inclusively the frequency of severe cases decreased from 19.2% of control group up to 8.9% and 4.3% in the active groups, respectively.
Conclusions:
Intravenous administration of 4 mg ondansetron effectively reduces vomiting occurring in more than 40% of patients after laparoscopic cholecystectomy, especially the frequency of severe cases, and mainly if administered before operation. The preparation is safe; no clinical or laboratory adverse reactions, complications have been observed in the studied patients.
Insights
Ondansetron injection significantly reduces postoperative nausea and vomiting after laparoscopic cholecystectomy. Administering this antiemetic before anesthesia is most effective and safe for patients.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Postoperative nausea and vomiting (PONV) are frequent complications of general anesthesia.
- 5-HT3 receptor antagonists, like ondansetron, are a key antiemetic class.
Purpose of the Study:
- To evaluate the efficacy and tolerability of ondansetron for PONV prevention.
- To compare the timing of ondansetron administration (pre-anesthesia vs. end of surgery).
Main Methods:
- Prospective, randomized, double-blind, placebo-controlled trial.
- 148 patients undergoing laparoscopic cholecystectomy.
- Three-arm study: placebo, ondansetron at end of anesthesia, ondansetron before anesthesia.
Main Results:
- Vomiting frequency decreased from 44.7% (placebo) to 28.9% (end) and 25.5% (before anesthesia).
- Severe vomiting cases reduced from 19.2% (placebo) to 8.9% (end) and 4.3% (before).
- Ondansetron was well-tolerated with no observed adverse events.
Conclusions:
- Intravenous ondansetron effectively reduces PONV after laparoscopic cholecystectomy.
- Pre-anesthesia administration of ondansetron offers the greatest benefit in reducing severe vomiting.
- Ondansetron is a safe antiemetic option for this patient population.