Postoperative nausea and vomiting after breast surgery: efficacy of prophylactic ondansetron and droperidol in a randomized placebo-controlled study

Omission of fentanyl during sevoflurane anesthesia decreases the incidences of postoperative nausea and vomiting and accelerates postanesthesia recovery in major breast cancer surgery

“…The incidence of nausea during the first 24 postoperative hours in group SF (68%) was almost comparable with that in previous reports of anesthesia without the use of prophylactic antiemetics (33%-85%) in major breast surgery [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. Many factors are thought to be involved in the high incidence of PONV [18,21].…”

“…In our study, the PONV incidences after PACU/SRA discharge (late PONV; 28% and 4% in groups SF and S, respectively) were lower than that during the PACU/ SRA stay (early PONV; 60% and 27%). Many studies have demonstrated that the incidence of late PONV was higher (or not lower) than that of early PONV in breast surgery with or without antiemetic prophylaxis [1][2][3]7,9]. In the earlier reports, patients were given opioids after PACU discharge, but no patient in our study received opioids postoperatively.…”

“…Our study suggests that the omission of fentanyl has a benefit similar to that of using the above antiemetics in reducing PONV frequencies in sevoflurane anesthesia in patients with major breast surgery. But others have reported that ondansetron (PONV incidence, 61% and 45%) [7], droperidol (PONV incidences, 50% and 37% [3]; and 61% and 48% [7]) and metoclopramide (PONV incidence, 50% and 43%) [3] were not necessarily effective in breast surgery. Pharmacological prophylaxis may increase costs and predispose to adverse events [6,21].…”

“…It has been recognized that major breast surgery is associated with a high incidence of PONV [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]18,21], and PONV is the major limiting factor for performing such surgery as a day procedure [11,21]. The incidence of nausea during the first 24 postoperative hours in group SF (68%) was almost comparable with that in previous reports of anesthesia without the use of prophylactic antiemetics (33%-85%) in major breast surgery [1][2][3][4][5][6][7][8][9][10][11][12][13][14].…”

“…Breast cancer surgery performed under general anesthesia using a volatile anesthetic is associated with high incidences (33%-85%) of postoperative nausea and vomiting (PONV) [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. Recently, not only minor breast operations, such as lumpectomy, but major operations, such as mastectomy, have been performed as ambulatory surgery or "drive-through mastectomy" in order to decrease healthcare costs and improve the patients' emotional and psychological well-being [11,[15][16][17].…”