Grover VK, Mathew PJ, Hegde H. Efficacy of orally disintegrating ondansetron in preventing postoperative nausea and vomiting after laparoscopic cholecystectomy: A randomised, double-blind placebo controlled study

Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Anaesthesia (Impact Factor: 3.38). 07/2009; 64(6):595-600. DOI: 10.1111/j.1365-2044.2008.05860.x
Source: PubMed


Peri-operative prophylactic anti-emetics are commonly used parenterally. Orally disintegrating ondansetron is efficacious during chemotherapy. Therefore, we aimed to study the efficacy of orally disintegrating ondansetron for postoperative nausea and vomiting. In a randomised, double-blind, placebo controlled trial on 109 patients scheduled for laparoscopic cholecystectomy, oral ondansetron was compared to intravenous ondansetron and placebo. The anaesthetic technique was standardised. Mean time (SD) to tolerating oral intake was delayed in the placebo group to 366.1 (77.6) min compared to oral 322.9 (63.7) min and intravenous 322.4 (65.2) min groups. This is corroborated by a higher incidence of nausea and vomiting in the control group during the first 6 h postoperatively (control 44.4%, oral 17.7%, intravenous 18.2%). There was no significant difference between oral and intravenous groups. In conclusion, orally disintegrating ondansetron was as efficacious as intravenous ondansetron in the peri-operative phase and may be a viable option for prophylaxis of emesis in day care surgery.

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    • "Ondansetron is a 5-HT3 receptor antagonist which has been documented to be an effective anti-emetic in preventing and treating PNOV with few side effects[12]. Orally disintegrating ondansetron has been shown to be effective in preventing chemotherapy induced nausea and vomiting[13, 14]. "
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    ABSTRACT: The aim of this study was to determine the effect of oral ondansetron in decreasing the vomiting due to acute gastroenteritis in children. In a single center, randomized, double blind, controlled trial, the effect of oral ondansetron was compared with placebo on 176 patients between 1 and 10 years old with acute gastroenteritis. 30 minutes after drug administration, oral rehydration therapy (ORT) was initiated. Severity of vomiting was evaluated during emergency department (ED) stay and 48 hours follow up. Data were collected and analyzed by SPSS16. Fifty two of children (58.5%) were males with the mean age of 3.12 (±2.30) years. Ten patients in ondansetron and 14 in placebo group had persistent vomiting during ED stay. After analyzing, there was no significant relation between vomiting in 4 and 48 hours and need for intra venous fluid therapy between the two groups although ondansetron generally decreased ORT failure (P=0.03). Although administrayion of oral ondansetron in gastroenteritis could decrease failure of ORT, it seems that further well-conducted clinical studies are needed to determine effects of oral ondansetron precisely.
    Iranian Journal of Pediatrics 10/2013; 23(5):557-63. · 0.52 Impact Factor
    • "Its overall incidence can rise to 80% in high-risk patients.[1] The incidence of PONV remains unacceptably high (40-75% in the first 24hrs, without active intervention) following laparoscopic cholecystectomy.[23] "
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    ABSTRACT: Incidence of postoperative nausea and vomiting (PONV), without active intervention, following laparoscopic cholecystectomy is unacceptably high. We evaluated the effectiveness of intravenous (IV) palonosetron in counteracting PONV during the first 24hrs following laparoscopic cholecystectomy, using ondansetron as the comparator drug. In a randomized, controlled, single blind, parallel group trial, single pre-induction IV doses of palonosetron (75mcg) or ondansetron (4mg) were administered to adult patients of either sex undergoing elective laparoscopic cholecystectomy. There were 49 subjects per group. The pre-anesthetic regimen, anesthesia procedure and laparoscopic technique were uniform. The primary effectiveness measure was total number of PONV episodes in the 24 hrs period following end of surgery. The frequencies of individual nausea, retching and vomiting episodes, visual analog scale (VAS) score for nausea at 2, 6 and 24hrs, use of rescue antiemetic (metoclopramide), number of complete responders (no PONV or use of rescue in 24 hrs) and adverse events were secondary measures. There was no statistically significant difference between the groups in primary outcome. Similarly, the frequencies of nausea, retching and vomiting episodes, when considered individually, did not show significant difference. Nausea score was comparable at all time points. With palonosetron, 14 subjects (28.6%) required rescue medication while 13 (26.5%) did so with ondansetron. The number of complete responders was 14 (28.6%) and 16 (32.7%), respectively. Adverse events were few and mild. QTc prolongation was not encountered. Palonosetron is comparable to ondansetron for PONV prophylaxis in elective laparoscopic cholecystectomy when administered as single pre-induction dose.
    Indian Journal of Pharmacology 03/2013; 45(1):24-9. DOI:10.4103/0253-7613.106430 · 0.69 Impact Factor
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    ABSTRACT: Das Konzept der Fast-track-Rehabilitation stellt einen multidisziplinären Ansatz dar, um das perioperative Ergebnis zu verbessern. Es wurde bislang in verschiedenen operativen Disziplinen etabliert. Auch im Bereich der Gefäßchirurgie konnten unter Befolgung eines Fast-track-Behandlungspfades gute Erfolge erzielt werden. Die positiven Effekte der Fast-track-Rehabilitation sind jedoch nur durch eine perioperative Kooperation aller beteiligten Professionen zu erzielen. Neben der operativen Fachabteilung hat insbesondere die Anästhesiologie durch ihren direkten Einfluss auf wesentliche Aspekte dieses Konzeptes einen bedeutenden Anteil am klinischen Therapieerfolg. In dieser Arbeit sollen die einzelnen anästhesiologischen Behandlungsansätze bei Anwendung der Fast-track-Rehabilitation im Bereich der Gefäßchirurgie näher betrachtet werden. The fast-track concept, a multidisciplinary approach to improve perioperative outcomes, has now been established in numerous surgical disciplines. Its application in vascular surgery has also been successfully demonstrated. The positive effects of fast-track rehabilitation can be achieved only by the cooperation of all professionals involved. Besides the surgeon, the anaesthesiologist plays a key role in perioperative management in fast-track programmes through his or her direct influence on substantial aspects of the fast-track concept. In this review, the authors describe therapeutic approaches of the anaesthesiologist using a fast-track concept in vascular surgery. SchlüsselwörterFast-track-Gefäßchirurgie-Aortenchirurgie-Anästhesie-Perioperative Medizin KeywordsFast-track-Vascular surgery-Aortic surgery-Anaesthesia-Perioperative medicine
    Gefässchirurgie 05/2010; 15(3):183-190. DOI:10.1007/s00772-009-0713-1 · 0.24 Impact Factor
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