A Comparison of Three Antiemetic Combinations for the Prevention of Postoperative Nausea and Vomiting

Sánchez-Ledesma, M.J.; López-Olaondo, L.; Pueyo, F. J.; Carrascosa, F.; Ortega, Ana

doi:10.1097/00000539-200212000-00022

Cited by 51 publications

(32 citation statements)

References 26 publications

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“…Based on Apfel's simplified risk score, the predicted incidence of PONV is 40-80% [8]. Sample size estimation was performed in accordance with the results of a previously published study [4]. In that study, the incidence of PONV was 30% in patients with morphine PCA receiving dexamethasone plus ondansetron for antiemetic prophylaxis.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Dexamethasone with Ondansetron or Haloperidol for Prevention of Patient‐Controlled Analgesia‐Related Postoperative Nausea and Vomiting: A Randomized Clinical Trial

et al. 2012

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The incidences of total PONV in the first 24 h in groups DH (35%) and DO (30%) were significantly lower than those of group D (57%) (p < 0.05 for each comparison). The differences between groups DH and DO were insignificant. The incidence of PONV was significantly smaller in the DH and DO groups than predicted by the patients’ underlying risks. Pain scores, sedation scores, and recovery times were similar among the three study groups, and no clinically relevant prolongation of the electrocardiographic QTc interval was observed in any patient. conclusions: Dexamethasone 5 mg with either haloperidol 2 mg or ondansetron 4 mg provides a better antiemetic effect than dexamethasone 5 mg alone in patients receiving postoperative morphine PCA.

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Section: Methodsmentioning

confidence: 99%

Comparison of Dexamethasone with Ondansetron or Haloperidol for Prevention of Patient‐Controlled Analgesia‐Related Postoperative Nausea and Vomiting: A Randomized Clinical Trial

et al. 2012

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“…Both combination regimens appear to be equally efficacious (IIA). 120,121 In addition to using a combination of antiemetics acting at different receptor sites, the multifactorial etiology of PONV might be better addressed by the adoption of a multimodal approach. This is especially important in patients at high risk for PONV.…”

Section: Combination Antiemetic Therapy and Multimodal Approachmentioning

confidence: 99%

Evidence-based management of postoperative nausea and vomiting: a review

Habib

Gan

2004

Can J Anesth/J Can Anesth

196

106

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P Pu ur rp po os se e: : To provide evidence-based guidelines for the prophylaxis and treatment of postoperative nausea and vomiting (PONV).S So ou ur rc ce e: : Literature from randomized controlled trials, systematic reviews, logistic regression analyses and expert opinion in the management of PONV.P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : The etiology of PONV is multifactorial. Patient, anesthesia, and surgery related risk factors have been identified. Universal PONV prophylaxis is not cost-effective. Identification of patients at high-risk of PONV allows targeting prophylaxis to those who will benefit most from it. No prophylaxis is needed for patients at low risk for PONV. For patients at moderate risk for PONV, prophylaxis using a single antiemetic or a combination of two agents should be considered. Double and triple antiemetic combinations should be considered for patients at high risk for PONV. Furthermore, a multimodal approach should be adopted incorporating steps to keep the baseline risk of PONV low. The optimum cost-effective approach to the management of PONV will differ between an ambulatory centre and an inpatient hospital setting. For the treatment of established PONV in patients who failed prophylaxis, patients should not receive a repeat dose of the prophylactic antiemetic. Rather, a drug acting at a different receptor should be used. Beyond six hours after surgery, patients can be treated with any of the agents used for prophylaxis, except dexamethasone and transdermal scopolamine.C Co on nc cl lu us si io on n: : PONV are common after anesthesia and surgery. We provided evidence-based guidelines for the management of this problem based on the available literature. Objectif : Énoncer des lignes de conduite fondées sur des données probantes pour la prévention et le traitement des nausées et des vomissements postopératoires (NVPO). Source : Les publications d'essais contrôlés et randomisés, les études méthodiques, les analyses de régression logistique et l'opinion d'experts sur le traitement des NVPO. Constatations principales : L'origine des NVPO est multifactorielle. Les facteurs de risque reliés au patient, à l'anesthésie et au type de chirurgie sont connus. La prévention universelle des NVPO n'est pas rentable. L'identification des patients à haut risque de NVPO permet

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“…No existe tampoco interacción aparente entre droperidol y dexametasona teniendo su combinación un perfil de seguridad similar (73). Cabe señalar, finalmente, que la mezcla en solución salina de droperidol y morfina es estable hasta 14 días (74).…”

Section: Tratamiento En El Adultounclassified

“…Pueyo et al efectuaron un análisis incremental de la relación coste/efectividad (129) tomando los datos de efectividad de una muestra de pacientes propia (73). Se…”

Section: Relación Coste-efectividadunclassified

Recomendaciones de prevención y tratamiento de las náuseas y vómitos postoperatorios y/o asociados a las infusiones de opioides

Gómez-Arnau

Aguilar

Bovaira

et al. 2010

Revista Española de Anestesiología y Reanimación

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Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Española de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating Este trabajo ha sido financiado mediante la concesión de una subvención de ProStrakan Farmacéutica SL a la Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor.Aceptado para su publicación en agosto de 2010.Rev. Esp. Anestesiol. Reanim. 2010; 57: 508-524. Reproducido con permiso de REDAR.

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A Comparison of Three Antiemetic Combinations for the Prevention of Postoperative Nausea and Vomiting

Cited by 51 publications

References 26 publications

Comparison of Dexamethasone with Ondansetron or Haloperidol for Prevention of Patient‐Controlled Analgesia‐Related Postoperative Nausea and Vomiting: A Randomized Clinical Trial

Comparison of Dexamethasone with Ondansetron or Haloperidol for Prevention of Patient‐Controlled Analgesia‐Related Postoperative Nausea and Vomiting: A Randomized Clinical Trial

Evidence-based management of postoperative nausea and vomiting: a review

Recomendaciones de prevención y tratamiento de las náuseas y vómitos postoperatorios y/o asociados a las infusiones de opioides

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