Ondansetron versus placebo for prophylaxis of nausea and vomiting in patients undergoing ambulatory laparoscopic cholecystectomy

Liberman, M. A.; Howe, S.C.; Lane, Michael A.

doi:10.1016/s0002-9610(99)00251-2

Cited by 62 publications

(57 citation statements)

References 13 publications

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“…anaesthesia (20), liberal fluid administration (13,21) and prophylactic antiemetic therapy including serotonergic receptor antagonists (22)(23)(24), dexamethasone (12,25) or combination therapies (4,(26)(27)(28). This is supported by our current anaesthetic regimen, in which moderate PONV was seen in 11% and severe PONV in 2%.…”

Section: Ponvmentioning

confidence: 84%

Post‐operative recovery profile after laparoscopic cholecystectomy: a prospective, observational study of a multimodal anaesthetic regime

Jensen

Kehlet

Lund

2007

Acta Anaesthesiol Scand

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Background: Laparoscopic cholecystectomy is now often an ambulatory procedure, but dependent on short-term postoperative complaints of pain and post-operative nausea and vomiting (PONV). The efficacy of post-anaesthesia care units (PACUs) is therefore important to facilitate return to normal functions. We investigated the feasibility and efficacy of a standardized, evidence-based anaesthesia/analgesic regime to identify residual problems in the early post-operative phase. Methods: One hundred and thirty-four consecutive patients admitted for elective laparoscopic cholecystectomy at Hvidovre University Hospital between 15 March and 30 September 2005 were included in the study. The standardized, evidence-based regime consisted of total intravenous (i.v.) anaesthesia (propofolremifentanil), well-defined fluid therapy, dexamethasone, ketorolac, ondansetron, sufentanil and incisional bupivacaine intraoperatively, and in the PACU on demand (prn) administration of sufentanil, morphine, paracetamol, ondansetron, droperidol, oral fluids and oxygen (if SpO 2 < 93%) with PACU discharge using a modified Aldrete score. Results: Protocol violations were moderate and occurred unsystematically, 8% had medical violations and 10% did not receive the pre-planned fluid amount. Severe PONV was seen in 2%.

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Section: Ponvmentioning

confidence: 84%

Post‐operative recovery profile after laparoscopic cholecystectomy: a prospective, observational study of a multimodal anaesthetic regime

Jensen

Kehlet

Lund

2007

Acta Anaesthesiol Scand

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“…The latter advantage has been negated by PONV, which is turning out to be the leading cause of unexpected re-admission after day surgery. 13,14 The incidence of PONV has been reported to be as high as 53-72%. 15 After laparoscopic cholecystectomy up to 70% patients have PONV if they are not on any antiemetic prophylaxis.…”

Section: Me Et Th Ho Od Ds S Following Approval From Our Institutiomentioning

confidence: 99%

“…18 Transdermal scopolamine decreases PONV after laparoscopic surgeries, but 91% of patients experience side effects. 13,22 Phenothiazines and antihistamines can produce sedation and lethargy. Metoclopramide is also an effective antiemetic but not without side effects including dystonic reactions, rest- FIGURE 2 Number of patients presenting with nausea or vomiting during the first six hours (N6 and V6) and from 6-24 hr (N6lessness and tachycardia.…”

Section: Me Et Th Ho Od Ds S Following Approval From Our Institutiomentioning

confidence: 99%

“…24 Ondansetron, a 5-hydroxy tryptamine subtype 3 (5HT3) receptor antagonist, is an effective antiemetic for the prevention and treatment of PONV. 1,13 It has been extremely useful in reducing PONV in women undergoing ambulatory gynecologic laparoscopic procedures. Despite its advantages, including minimal side effects, it is expensive compared with other antiemetics and may consume a major portion of an anesthetic pharmacy budget.…”

Section: Me Et Th Ho Od Ds S Following Approval From Our Institutiomentioning

confidence: 99%

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Acupressure and ondansetron for postoperative nausea and vomiting after laparoscopic cholecystectomy

Agarwal

Bose

Gaur

et al. 2002

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : To compare the efficacy of acupressure wrist bands and ondansetron for the prevention of postoperative nausea and vomiting (PONV).M Me et th ho od ds s: : One hundred and fifty ASA I-II, patients undergoing elective laparoscopic cholecystectomy were included in a randomized, prospective, double-blind and placebo-controlled study. Patients were divided into three groups of 50. Group I was the control; Group II received ondansetron 4 mg iv just prior to induction of anesthesia; in Group III acupressure wristbands were applied at the P6 points. Acupressure wrist bands were placed inappropriately in Groups I and II. The acupressure wrist bands were applied 30 min prior to induction of anesthesia and removed six hours following surgery. Anesthesia was standardized. PONV were evaluated separately as none, mild, moderate or severe within six hours of patients' arrival in the postanesthesia care unit and then at 24 hr after surgery by a blinded observer. If patients vomited more than once, they were given 4 mg ondansetron iv as the rescue antiemetic. Results were analyzed by Z test. A P value of < 0.05 was taken as significant. R Re es su ul lt ts s: : The incidence of PONV and the requirement of rescue medication were significantly lower in both the acupressure and ondansetron groups during the first six hours.C Co on nc cl lu us si io on n: : Acupressure at P6 causes a significant reduction in the incidence of PONV and the requirement for rescue medication in the first six hours following laparoscopic cholecystectomy, similar to that of ondansetron 4 mg iv. Objectif : Comparer l'efficacité des bandes d'acupression et de l'ondansétron comme prévention des nausées et vomissements postopératoires (NVPO). Méthode : Cent cinquante patients d'état physique ASA I-II devant subir une cholécystectomie laparoscopique ont été recrutés pour une étude prospective, randomisée et à double insu contre placebo. Ils ont été répartis en trois groupes de 50. Le groupe I a été le groupe témoin; les patients du groupe II ont reçu 4 mg iv d'ondansétron juste avant l'induction de l'anesthésie; chez les patients du groupe III, on a appliqué des bandes d'acupression aux point P6. Des bandes d'acupression ont été placées de façon inappropriée chez les patients des groupes I et II. Les bandes ont été appliquées 30 min avant l'induction

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“…A readmission rate of 1.8% for our patients is in accordance to that (2%) reported in several studies. [26,27] Postoperative nausea and vomiting (PNOV) are the leading postoperative complications in cases of DSLC, several randomised controlled studies reported its occurrence yet there is no fixed nor specific pre-anesthetic drug regimens to treat such symptoms [28] Postoperative nausea and vomiting with DSLC surgery is responsible for about 0.1 -0.2% of unanticipated admissions [29] . In our study, few patients suffered from PONV that is why we report a 97% success rate of day surgery cases discharge Postoperative pain prolonged hospital stays in the ambulatory setting [30].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic cholecystectomy as a day surgery operation: two centers experience.

Ghnnam¹,

Ellatif²,

Elbeshry³

et al. 2017

Int J Surg Med

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Background: Day-surgery, laparoscopic cholecystectomy (DSLC) becomes the standard management of chronic gall bladder diseases worldwide due to its safety and feasibility. The aim of our study was to assess DSLC at two secondary care governmental hospitals in Saudi Arabia with a separate day-surgery unit regarding complications, same-day discharge, to identify problems associated with the early discharge, and determine the degree of patient satisfaction. Methods: Over a 3-years period, all patients undergoing elective laparoscopic cholecystectomy under the authors were prospectively studied. All patients were asked on following up post-operatively about their satisfaction and recommendation of DSLC for their relatives and friends. Results: Eight hundred and sixteen patients underwent elective day surgery laparoscopic cholecystectomies, predominantly female (89.7%) and ASA I (77.2%) with a mean age 38.1 2 18.7 years. Eighty-eight percent of patients were discharged directly from the day surgery unit, and further 1.6% of patients (so nearly 89.6% of the patients) were discharged within 24 hours from the operation. Readmission following hospital discharges was necessary for three patients (0.37%). The overall rate of complications were 1.35% (11patients). At follow-up, 701 patients (97.36%) were satisfied with their experience undergoing DSLC. Conclusions: Our findings confirmed that DSLC is safe and feasible. Many patients showed high satisfaction with their length of stay and day surgery ward care although we extend the criteria for DSLC.

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Ondansetron versus placebo for prophylaxis of nausea and vomiting in patients undergoing ambulatory laparoscopic cholecystectomy

Cited by 62 publications

References 13 publications

Post‐operative recovery profile after laparoscopic cholecystectomy: a prospective, observational study of a multimodal anaesthetic regime

Post‐operative recovery profile after laparoscopic cholecystectomy: a prospective, observational study of a multimodal anaesthetic regime

Acupressure and ondansetron for postoperative nausea and vomiting after laparoscopic cholecystectomy

Laparoscopic cholecystectomy as a day surgery operation: two centers experience.

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