Intramuscular ephedrine reduces emesis during the first three hours after abdominal hysterectomy

Abstract

Ephedrine 0.5 mg/kg i.m. administered at the end of abdominal hysterectomy has a significant antiemetic effect during the first 3 h after administration with no evident side-effects.

Náuseas e vômitos no pós-operatório: uma revisão do "pequeno-grande" problema

“…As fenotiazidas (prometazina e proclorperazina) são eficazes se administradas no final da cirurgia, mas os seus efeitos adversos (sedação, tonturas, desidratação) limitam a sua utilização principalmente em regime ambulatorial 36 . A efedrina por via muscular parece ser eficaz, principalmente se as náuseas e os vômitos estão associados à desidratação ou hipotensão arterial 37 .…”

“…Phenothyazides (prometazine and proclhorperazine) are effective if administered at surgery completion, but their adverse effects (sedation, dizziness and dehydration) limit its use, especially in outpatient regimen 36 . Intramuscular ephedrine seems to be effective, especially if nausea and vomiting are associated to dehydration or hypotension 37 . Non-pharmacological techniques: acupuncture, compression, intradermal nervous stimulation and hypnosis were effective if used before surgery 38 , but they lack further evaluation.…”

Use of Ephedrine for the Short-Term Treatment of Postoperative Nausea and Vomiting: A Case Report

“…However, in the study by Hagemann et al, 8 both hypotensive and normotensive patients responded to ephedrine. Furthermore, studies in 1968, establishing the antimotion sickness actions of ephedrine, demonstrated that the action of ephedrine was not impacted by the subjects' BP.…”

“…Although efficacy remained at 24 hours after administration in two of the studies, in the study by Hagemann et al, 8 ephedrine was found to be effective for only about 3 hours. Moreover, as an antiemetic, ephedrine is administered IM because IV administration would have cardiovascular effects not seen with IM administration in healthy individuals.…”

“…[10][11][12] In addition, ephedrine does not cause sedation. 8,9 In the study by Rothenberg et al, ephedrine was found to be as effective as droperidol but with significantly lower sedation scores than both droperidol and saline. Ephedrine is contraindicated in patients taking monoamine oxidase inhibitors and patients with dysrhythmias or angleclosure glaucoma.…”