Evaluation of Ondansetron-induced QT interval prolongation in the prophylaxis of postoperative emesis

To avert nausea and vomiting the 5-Hydroxytryptamine3 (5-HT3) antagonists have become the first line of treatment ifassociated with cardiovascular effects andappear to cause QT prolongation.

Evaluate the effect of 1 mg, 4 mg, and 8 mg bolus doses of intravenous Ondansetron, relative to placebo, in prevention of postoperative nausea and vomiting (PONV) and to find out the changes of QT interval corrected for heart rate (QTc).

This prospective randomized, placebo-controlled, double-blind study was carried out among 136 adult participants of both sexes in a tertiary care postgraduate teaching institute at Kolkata. mg, 4 mg or 8 mg inj. Ondansetron was diluted to 10 ml with normal saline, was infused 30 min before extubation in relation with a control group. Time to first rescue antiemetic medication and in QTc interval at different time intervals, in each group was noted in different in the various surgical operation theaters (OTs).

Requirement of the first rescue antiemetic in the postoperative period between 60 to 120 min in the mg, 4 mg or 8 mg Ondansetron groups was in 28%, 24% and 7% participants respectively; between 120 to 240 min in 63%, 72% and 57% respectively; and within 360 min in 9%, 4% and 36% respectively. Significant and maximal QTc prolongation was observed in the participants with mg or 8 mg Ondansetron 3 and 5 min of drug administration.

One mg Ondansetron in healthy adult participants can effectively prevent PONV causing no or insignificant prolongation of QTc interval.