PT  - JOURNAL ARTICLE
AU  - Kaki, Abdullah M.
AU  - Abd El-Hakeem, Essam E.
TI  - Prophylaxis of postoperative nausea and vomiting with ondansetron, metoclopramide, or placebo in total intravenous anesthesia patients undergoing laparoscopic cholecystectomy
DP  - 2008 Oct 01
TA  - Saudi Medical Journal
PG  - 1408--1413
VI  - 29
IP  - 10
4099  - http://smj.org.sa/content/29/10/1408.short
4100  - http://smj.org.sa/content/29/10/1408.full
SO  - Saudi Med J2008 Oct 01; 29
AB  - OBJECTIVE: To compare total intravenous anesthesia (TIVA) with ondansetron, and metoclopramide in preventing postoperative nausea and vomiting (PONV) in laparoscopic cholecystectomy patients.METHODS: A prospective randomized double-blinded study was performed at King Abdulaziz University Hospital, Jeddah, Saudi Arabia in 2007. Seventy-five patients scheduled for laparoscopic cholecystectomy under TIVA were randomized to receive either: metoclopramide 10 mg (n=25), 4 mg ondansetron (n=25), or placebo (n=25) at the end of surgery. Postoperative nausea and vomiting episodes, analgesic supply, rescue medication, adverse events, and patient satisfaction were collected over 24 hours.RESULTS: Nineteen patients developed PONV. The frequencies of PONV were equal for the 2 groups (28%), and lower among the ondansetron group (20%) (p&amp;gt;0.05). Female gender, lengthy surgery, and longer hospital stay were associated with more frequent PONV regardless of the study group (p&amp;lt;0.05). Patient&#039;s satisfaction was more frequent among the ondansetron group (p&amp;gt;0.05). Morphine consumption was associated with more PONV, but it was statistically significant only in the placebo group. There was no difference between the 3 groups with regard to the VAS pain score, cardiovascular parameters, or oxygen saturation.CONCLUSION: It is unlikely that a single technique or drug will ever be effective in treating emesis under all surgical circumstances. Therefore, a multimodal regimen incorporating avoidance of emesis triggering factors, and administration of antiemetic medications is recommended.