Transcutaneous nicotine does not prevent postoperative nausea and vomiting: a randomized controlled trial

Area of Science:

• Anesthesiology
• Pharmacology
• Clinical Research

Background:

• Empirical evidence suggests smokers experience less postoperative nausea and vomiting (PONV).
• The potential prophylactic effect of nicotine on PONV in non-smokers requires investigation.

Purpose of the Study:

• To determine if transdermal nicotine administration can prevent PONV in non-smokers undergoing general anesthesia.

Main Methods:

• A randomized, placebo-controlled trial involving 90 non-smokers.
• Participants received either a 10cm(2) Nicotinell Patch (17.5mg nicotine) or a placebo patch one hour before surgery.
• Patches remained in place for 24 hours post-surgery or until PONV symptoms occurred.

Main Results:

• No significant difference in the incidence of nausea or vomiting between the nicotine and placebo groups within 24 hours.
• PONV symptoms tended to emerge earlier in the nicotine group.
• A significantly higher incidence of insomnia was reported in the nicotine group (26.7% vs. 6.8% placebo, P=0.01).

Conclusions:

• Prophylactic nicotine patches did not reduce the incidence of PONV in non-smokers.
• Nicotine administration may lead to earlier onset of PONV symptoms.
• Transdermal nicotine use significantly increases the risk of postoperative insomnia.