Prophylactic ondansetron for postoperative emesis.Meta‐analysis of its effectiveness in patients with previous history of postoperative nausea and vomiting

Abstract

The effectiveness of ondansetron in the prevention of postoperative vomiting is not affected by the patients' PH-PONV.

Palonosetron has superior prophylactic antiemetic efficacy compared with ondansetron or ramosetron in high-risk patients undergoing laparoscopic surgery: a prospective, randomized, double-blinded study

“…Adding a basal infusion to IV-PCA could be more convenient in surgery and more effective in reducing resting pain than bolus demand only, but it may be associated with a greater risk of PONV. In addition, other reasons for unsatisfactory antiemetic effects of ondansetron given prophylactically are the timing of administration [17], the dose of ondansetrone [18], and CYP2D6 alleles polymorphisms [19]. …”

Comparison of the effects of sugammadex and neostigmine on postoperative nausea and vomiting

“…Additionally at the end of the surgical procedure the majority of times the residual neuromuscular block is reversed with acetyl choline esterase inhibitors. 6 Cholinesterase inhibitors have been implicated in the development of PONV as a result of their potent muscarinic effects upon the gastrointestinal tract and the vomiting center in the brain. 7 Neostigmine, used at the end of surgery for residual neuromuscular block, is associated with increased the risk of PONV, especially when used in large doses (>2.5 mg).…”

Anesthesia and the gastrointestinal tract

“…In another metaanalysis comparing patients with and without a previous history of PONV, there was no significant difference in the effectiveness of ondansetron for vomiting within the first 24 h postoperatively, at 4 mg i.v. [86]. There was a trend to effectiveness at 8 mg i.v., but this effect was not statistically significant.…”