Evaluation of methylnaltrexone for the reduction of postoperative vomiting and nausea incidences

We examined the effect of methylnaltrexone on the incidence of postoperative nausea and vomiting in a prospective double-blind placebo controlled study. One hundred and twenty female patients undergoing laparoscopic major gynecological surgery were allocated randomly to receive either 20 mg methylnaltrexone or placebo IV at the end of surgery. Postoperative nausea and vomiting was evaluated for 6 h after admission to the PACU and assessed by number of episodes and degree of severity. The incidences of nausea and vomiting for the placebo group were 27 and 18 percent, respectively. The corresponding values for the methylnaltrexone group were 20 and 10 percent. We conclude that methylnaltrexone did not prevent nor significantly reduced the incidence and severity of postoperative nausea and vomiting following a balanced anesthetic technique in gynecological procedures.