Transdermal hyoscine and postoperative nausea and vomiting

Area of Science:

• Anesthesiology
• Pharmacology
• Gynecological Surgery

Background:

• Postoperative nausea and vomiting (PONV) are common complications following major gynecological surgery.
• Effective pharmacological interventions are crucial for improving patient recovery and satisfaction.

Purpose of the Study:

• To evaluate the efficacy and safety of transdermal hyoscine patches in managing PONV in patients undergoing major gynecological surgery.

Main Methods:

• A randomized, double-blind, placebo-controlled trial involving 42 patients undergoing major gynecological surgery.
• Patients received either a hyoscine patch or a placebo patch applied behind the ear.
• Follow-up occurred at 24-hour intervals for 3 days postoperatively, with data analyzed using matched pairs.

Main Results:

• A statistically significant reduction (p < 0.01) in nausea and vomiting was observed in the hyoscine group within the first 24 hours postoperatively.
• No significant difference in PONV incidence was found between groups after the initial 24-hour period.
• An increased incidence of visual disturbances was noted in the hyoscine group at 48 hours, with no other significant differences in side effects.
• Despite hyoscine treatment, 68% of patients experienced severe nausea and vomiting.

Conclusions:

• Transdermal hyoscine demonstrates efficacy in reducing early postoperative nausea and vomiting after major gynecological surgery.
• The antiemetic effect of hyoscine appears transient, with limited benefit beyond 24 hours.
• Hyoscine treatment is associated with a potential increase in visual disturbances and a high rate of severe PONV, warranting careful consideration of its use.