hysterectomy ondansetron

BACKGROUND AND OBJECTIVE: Patients undergoing total abdominal hysterectomy under general anaesthesia have a high risk of developing postoperative nausea and vomiting (PONV). The aim of this study was to evaluate the incidence of PONV in patients undergoing total abdominal hysterectomy under spinal anaesthesia with intravenous patient-controlled analgesia (PCA) using morphine and to compare its incidence with and without antiemetic prophylaxis. METHODS: Thirty-four patients undergoing total abdominal hysterectomy under spinal anaesthesia with i...

PURPOSE: To evaluate the prophylactic effect of ondansetron on nausea and vomiting following epidural morphine for postoperative pain control. METHODS: Seventy women (n = 35 in each group) undergoing abdominal total hysterectomy under epidural anesthesia were enrolled in this randomized, double-blinded, and placebo-controlled study. At the end of surgery, all patients received epidural morphine 3 mg for postoperative pain relief. Before morphine injection, the ondansetron group received iv ondansetron 4 mg, whereas the placebo group received iv saline...

Following the establishment of an acute pain service in one UK acute NHS trust, including the introduction of patient-controlled analgesia (PCA), pain scoring, and a rationalization of the use of simple analgesics, attention was drawn to an apparent increase in postoperative nausea and vomiting (PONV) among women given PCA following abdominal hysterectomy. Audits were conducted into clinical practice and patient satisfaction and it was agreed that an evaluation of the evidence should be conducted to ensure that the correct direction for development in the management of PONV could be established...

BACKGROUND: Postoperative nausea and vomiting (PONV) is a significant problem in surgical patients. The 5-hydroxytryptamine3-receptor antagonists ondansetron, dolasetron, and granisetron are being used to prevent PONV and avoid the adverse events associated with traditional antiemetics such as antihistaminic agents, anticholinergic agents, and dopamine antagonists. OBJECTIVE: Because practitioners have taken widely differing approaches to the selection and dosing of agents in this class, this retrospective study assessed the relative efficacy of i...

BACKGROUND AND OBJECTIVES: We assessed the efficacy and safety of dipyrone in comparison with tramadol in the relief of early postoperative pain following abdominal hysterectomy. METHODS: A total of 151 women between 18 and 60 years of age undergoing abdominal hysterectomy during general anesthesia participated in a randomized, double-blind, controlled, multicenter study. Seventy-three patients received dipyrone and 78 received tramadol. Patients received an intravenous loading dose of the study drug immediately after operation followed by intravenous (IV) maintenance infusion and IV on-demand boluses up to a maximum number of predetermined doses/day of 8 g dipyrone and 500 mg tramadol...

In a randomised, double-blind trial, we compared the use of ondansetron and droperidol for the prevention of nausea and vomiting after total abdominal hysterectomy, during patient-controlled analgesia with morphine. One hundred and forty-two patients were randomly allocated to one of two groups. All patients received a standardised general anaesthetic and postoperative analgesic regimen. One group received ondansetron 4 mg at induction of anaesthesia, and ondansetron 0.13 mg with each 1-mg bolus dose of morphine...

BACKGROUND: The safety and antiemetic efficacy of CP-122,721, a novel neurokinin-1 antagonist, was evaluated when administered alone or in combination with ondansetron. METHODS: Using a randomized, double-blind, placebo-controlled study design, CP-122,721 was initially compared with placebo and subsequently to ondansetron alone and in combination for prophylaxis against postoperative nausea and vomiting in 243 women undergoing abdominal hysterectomy. In the dose-ranging studies (n = 86), patients received either CP-122,721 100 mg (vs...

BACKGROUND: We tested the hypothesis that intramuscularly administered ephedrine prevents postoperative nausea and vomiting. Ephedrine is cheap, and for this indication poorly documented. METHODS: One hundred and nine patients undergoing elective abdominal hysterectomy under general anaesthesia were studied in a randomized, double-blind placebo-controlled study. Ten minutes before the end of the procedure patients received either ephedrine 0.5 mg/kg i.m. or placebo...

We have performed a randomized, double-blind study comparing droperidol and high-dose ondansetron mixed with morphine for patient-controlled analgesia (PCA). To detect a reduction in the incidence of postoperative nausea and vomiting from 55% to 20% with a power of 80% at the P < 0.05 level, 29 patients per group were required. We studied 60 healthy women undergoing abdominal hysterectomy, anaesthetized using a standard technique. Group D received a bolus dose of droperidol 1.25 mg at induction followed by droperidol 0...

STUDY OBJECTIVES: To investigate the hypothesis that the combination of ondansetron and droperidol would be more effective than droperidol alone in reducing nausea and vomiting. DESIGN: Randomized, doubleblind study. SETTING: Magee-Womens Hospital, Pittsburgh, Pennsylvania. PATIENTS: 160 healthy, ASA physical status I and II, female patients scheduled for total abdominal hysterectomy. INTERVENTIONS: After induction of anesthesia with propofol, Group 1 received intravenous (i...

A 41-year-old woman with a strong history of postoperative nausea and vomiting presented for abdominal hysterectomy 3 months after a previous anaesthetic where ondansetron prophylaxis had been used. She had developed a severe acute major depression disorder almost immediately thereafter, possibly related to the use of a serotonin antagonist. Nine years before she had experienced a self-limited puerperal depressive episode. Anaesthesia with a propofol infusion and avoidance of serotonin antagonists provided a nausea-free postoperative course without exacerbation of the depression disorder...

The efficacy of ondansetron 4 mg was compared with metoclopramide 10 mg for the prevention of post-operative nausea and vomiting in patients after major gynaecological abdominal surgery. Anaesthesia was standardized using thiopentone, atracurium and methadone for induction followed by isoflurane in nitrous oxide-oxygen mixture. Fifty patients were randomized in a double-blind fashion to either receive intravenous (i.v.) ondansetron 4 mg or metoclopramide 10 mg during closure of the pelvic peritoneum. The incidence and frequency of vomiting, and the incidence of severe nausea was recorded for 24 h after surgery...

A double-blind, randomised, placebo-controlled study was performed to assess the antiemetic efficacy of ondansetron in women receiving morphine from a patient-controlled analgesia system after total abdominal hysterectomy. Sixty-six ASA grade 1 or 2 patients scheduled for total abdominal hysterectomy were randomly allocated into one of two groups. All patients received a standardised anaesthetic and postoperative patient-controlled analgesia regimen. Group 1 received ondansetron 4 mg at induction of anaesthesia, repeated 8 h later...

The effect of a single intravenous dose of ondansetron in preventing postoperative nausea and emesis (retching and vomiting) (PONV) was investigated in a randomized, double-blind, placebo-controlled, multicentre, international study. Women of ASA class I-III, requiring gynaecological laparotomy, vaginal hysterectomy, or major vaginal surgery were selected for study. Two hundred and thirty-five received placebo, 231 received 1 mg ondansetron, 228 received 8 mg ondansetron and 229 received 16 mg ondansetron, as an infusion over five minutes before the induction of anaesthesia...

The prophylactic antiemetic efficacy of intravenous (i.v.) ondansetron, droperidol, perphenazine, and metoclopramide was evaluated in a prospective, double-blind study of 360 ASA physical status I-III patients undergoing total abdominal hysterectomy (TAH). Subjects were randomized to receive i.v., one of ondansetron 4 mg, droperidol 1.25 mg, perphenazine 5 mg, metoclopramide 10 mg, or placebo prior to induction of anesthesia. Hypotension immediately after administration of metoclopramide was observed in two patients and four patients given ondansetron developed profound systolic hypotension at induction of anesthesia...

The effect of ondansetron, a 5-HT3 antagonist, in preventing postoperative nausea and vomiting was investigated in a randomized, double-blind, placebo-controlled study of 84 patients undergoing gynecologic operation and receiving the same general anesthetic. The patients received premedication with either 16 mg oral ondansetron, or a matching placebo. The same medication was given postoperatively 8 h after the first dose. During the first hour after recovery from anesthesia, the frequencies of nausea and vomiting were 52% and 40%, respectively, in patients given placebos...

The effect of three times daily oral ondansetron in preventing postoperative nausea and vomiting was investigated in two randomized, double-blind, placebo-controlled, multi-centre studies. The first study compared ondansetron 1, 8 and 16 mg to placebo, and the second study compared 8 mg ondansetron to placebo. Both studies included ASA Class I-III female patients about to undergo major abdominal gynaecological surgery or vaginal hysterectomy. In the first study, the 8 and 16 mg ondansetron groups had a significantly lower incidence of nausea and vomiting in the 0-24 h period following recovery from anaesthesia than the placebo group...