Comparison of the Use of Domperidone, Droperidol and Metoclopramide in the Prevention of Nausea and Vomiting Following Major Gynaecological Surgery

Abstract

Domperidone 20 mg, droperidol 2.5 mg, metoclopramide 10 mg and placebo (saline) were given i.v. 10 min before the end of anaesthesia, to 200 women undergoing major gynaecological surgery, and the incidence of postoperative nausea and vomiting following a standard anaesthetic technique was assessed. Droperidol was significantly more effective than domperidone, metoclopramide or placebo in reducing emetic sequelae. There were no significant differences between the groups in the incidence of extrapyramidal effects and postoperative sedation. Patients given droperidol required less postoperative analgesia than those given domperidone or metoclopramide. It was concluded that, of the drugs studied, droperidol alone was effective in protecting against nausea and vomiting after major gynaecological surgery.

5-HT3 receptor antagonistsvs traditional agents for the prophylaxis of postoperative nausea and vomiting

“…30,37,42,48,51 Similarly, no common factor was found among them that would explain these differences. The overall analyses of these two endpoints were repeated without the anomalous trials which further strengthened the estimated beneficial effects of 5-HT 3 …”

“…2 Besides the discomfort caused by nausea and vomiting following surgery, PONV can contribute to the development of aspiration, wound dehiscence and increased bleeding. 3 Patients who experience PONV consume more resources and require additional health care professional time than do those in whom these complications are avoided. 4 This increased resource consumption leads to a higher cost of care from the hospital perspective and a higher cost to the patient.…”

“…Furthermore, the results of these trials have been divergent and inconsistent. There is a theoretical basis for a difference in efficacy between the 5-HT 3 antagonists and traditional agents because of their distinct mechanisms of action. The traditional agents are primarily dopamine receptor antagonists whereas the 5-HT 3 antagonist act on serotonin receptors.…”

“…The traditional agents are primarily dopamine receptor antagonists whereas the 5-HT 3 antagonist act on serotonin receptors. 52 The purpose of this quantitative systematic review was to evaluate the effectiveness of 5HT 3 receptor antagonists compared to traditional antiemetics for the prevention of PONV in all types of surgery.…”

Cost-effectiveness of prophylactic dolasétron or droperidolvs rescue therapy in the prevention of PONV in ambulatory gynecologic surgery

“…2 Besides the discomfort caused by nausea and vomiting following surgery, PONV can contribute to the development of aspiration, wound dehiscence and increased bleeding. 3 Patients who experience PONV consume more resources and require additional health care professional time compared with those in whom these complications are avoided. This increased resource consumption leads to a higher cost of care from the hospital's perspective and a higher cost to the patient.…”