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Revista Cubana de Anestesiología y Reanimación

2020, Number 3

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Revista Cubana de Anestesiología y Reanimación 2020; 19 (3)

Usefulness of ondansetron versus dexamethasone as postoperative antiemetic prophylaxis during major gynecologic surgery

González LA, Garí ML, López RJA, Sarabia AAM, Romero GG

Language: Spanish
References: 28
Page: 1-10
PDF size: 293.05 Kb.


ABSTRACT

Introduction: Postoperative nausea and vomiting are an unwanted sequel during the anesthetic recovery stage.
Objective: To evaluate the usefulness of dexamethasone compared with ondansetron for the prevention of postoperative nausea and vomiting after major gynecological surgical procedures, under general orotracheal anesthesia.
Method: A prospective, analytical and observational study was carried out with 84 patients older than 19 years of age, at Miguel Enríquez Hospital Clinical-Surgical Hospital, from October 2018 to September 2019, divided sequentially, in order of arrival at the surgical unit, into two groups. The group 1 was administered dexamethasone (4 mg intravenously), and the group 2 was administered ondansetron (4 mg), 30 min before the end of the surgery.
Results: The average risk of postoperative nausea and vomiting prevailed significantly among patients aged 41-50 years. Excellent and good conditions predominated (p>0.05) in terms of effectiveness of prophylactic treatment. Headache prevailed significantly in the group 2. Most of the patients did not present adverse events.
Conclusions: Ondansetron and dexamethasone are useful for postoperative nausea and vomiting prophylaxis among patients who received major gynecological surgery, under general orotracheal anesthesia, a reason why it is considered a safe treatment, with mild adverse events and easy control.


REFERENCES

  1. Apfel C, Kortilla K, Abdalla M, Kerger H, Turan A, Vedder I. A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. N Engl J Med. 2008;350(24):2441-51.

  2. Gan TJ, Diemunsch AS, Habib A, Kovac P, Kranke TA. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2014;118(2):85-113.

  3. Castillo E, Hernández V, Quintana C, Elgueta A. Prevención y tratamiento de náuseas y vómitos postoperatorios. Cuad. Cir. 2011;25:75-806.

  4. Smith HS, Laufer A. Opioid induced nausea and vomiting. Eur J Pharmacol. 2014;5:722:67-78.

  5. Leslie K, Myles P, Chan M, Forbes A, Paech M, Peyton P, et al. Nitrous oxide and long-termmorbidity and mortality in the ENIGMA trial. Anesthesia-analgesia. 2011;101(2):387-93.

  6. Andrés Clavache J, Guzmán L, Gómez Buitrago LM, García Torres C, Torres M, Buitrago G, Gaitán Duarte H. Manual de práctica clínica basado en la evidencia: manejo de complicaciones posquirúrgicas. Revista Colombiana de Anestesiología. 2015;43(1):51-60.

  7. Hurtado López LM, Basurto Kuba E, Montes de Oca Durán ER. Prevalencia de fibroma uterino en el valle de México. Cir Cir. 2011;79:114-17.

  8. Borendal Wodlin N, Nilsson L, Carlsson P. Cost-effectiveness of general anesthesia vs spinal anesthesia in fast-track abdominal benign hysterectomy. Am J Obstet Gynecol. 2011;205:326.

  9. Veiga Gil L, Pueyo L, López Olaondo L. Náuseas y vómitos posoperatorios: fisiopatología, factores de riesgo, profilaxis y tratamiento. Revista Española de Anestesiología y Reanimación. 2017[acceso: 23/03/2019];64(4):223-32. Disponible en: adaarc.org.ar/wp-content/uploads/2017/05/NVPO.pdf

  10. Henzi I, Walder B, Tramer M. Dexamethasone forth e prevention of postoperative nausea and vomiting: A quantitatives sytematic review. Anesth Analg. 2012;90:186-94.

  11. Habib AS, El-Moalem H, Gan T. The efficacy of the 5-HT receptor antagonists combined with droperidol for PONV prophylaxis is similar to their combination with dexamethasone. A metaanalysis of randomized controlled trials. Can J Anaesth. 2004;51:311-19.

  12. Lickert JB, Shim YH, Lee YW, Lee JS, Choi JR, Chang CH. Incidence and risk factors of postoperative nausea and vomiting in patients with fentanyl-based intravenous patient-controlled analgesia and single antiemetic prophylaxis. Yonsei Med J. 2014;55(5):1430-5.

  13. Andrews PL J. Nausea and the quest for the perfect anti-emetic. Eur J Pharmacol. 2014;5:108-21.

  14. De la Paz Estrada C, Céspedes Cuenca Y. Diclofenaco vs metamizol en analgesia preventiva para cirugía ginecológica. Revista Mexicana de Anestesiología. 2009;32(4):209-13.

  15. Rüsch D, Eberhart LH, Wallenborn J. Nausea and vomiting after surgery under general anesthesia: an evidence-based review concerning risk assessment, prevention, and treatment. Dtsch ArzteblInt. 2010;107(42):733-41.

  16. Cohen MM, Duncan PG, Deboer DP, Tweed WA. The postoperative interview: assessing risk factors for nausea and vomiting. Anesth Analg. 1994;78:7-16.

  17. Sanabria A, Gómez X, Domínguez LC, Vega V, Osorio C. Histerectomía total basada en la evidencia, análisis de impacto presupuestario. Rev Colomb Cir. 2012;27:30-39.

  18. Seung-hwa R, JaeHwa Y, MunGyu K, Ki Hoon L, SoonIm K. The effect of combination treatment using palonosetron and dexamethasone for the prevention of postoperative nausea and vomiting versus dexamethasone alone in women receiving intravenous patient-controlled analgesia. Korean J Anesthesiol. 2015;68(3):267-73.

  19. Veitía Wilson EC, Martínez Leyva L, Amable Díaz T, Martínez Romero M, Morales Martínez I. Terapia combinada en la profilaxis de las náuseas y vómitos postoperatorios en cirugía laparoscópica. Revista Cubana de Medicina Militar. 2019[acceso: 23/03/2019];48(4):855-74. Disponible en: http://revmedmilitar.sld.cu/index.php/mil/article/view/326

  20. Alghanem SM, Massad IM, Rashed EM, Abu-Ali HM, Daradkeh SS. Optimization of anesthesia antiemetic measures versus combination therapy using dexamethasone or ondansetron for the prevention of postoperative nausea and vomiting. Surg Endosc. 2010;24(2):353-8.

  21. Harihar V, Vijay G, Rashmi V, Sunilkumar KS. Efficacy of orally disintegrating film of ondansetron versus intravenous ondansetron in prophylaxis of postoperative nausea and vomiting in patients undergoing elective gynaecological laparoscopic procedures: A prospective randomised, double-blind placebo-controlled study. Indian J Anaesth. 2014;58(4):423-9.

  22. Demirhan A, Tekelioglu YU, Akkaya A, Ozlu T, Yildiz I, Bayir H, et al. Antiemetic effects of dexamethasone and ondansetron combination during cesarean section sunder spinal anaesthesia. Afr Health Sci. 2013;13(2):475-82.

  23. Waldron NH, Jones CA, Gan TJ, Allen TK, Habib AS. Impact of perioperative dexamethasone on postoperative analgesia and side-effects: systematic review and meta-analysis. Br J Anaesth. 2013;110(2):191-200.

  24. De Oliveira GS, Castro Alves LJ, Ahmad S, McCarthy RJ. Dexamethasone to prevent postoperative nausea and vomiting: an updated meta-analysis of randomized controlled trials. Anesth Analg. 2013;116(1):58-74.

  25. Lee MJ, Lee KC, Kim HY, Lee WS, Seo WJ, Lee C. Comparison of ramosetron plus dexamethasone with ramosetron alone on postoperative nausea, vomiting, shivering and pain after thyroid surgery. Korean J Pain. 2015[acceso: 24/03/2019];28(1):39-44. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/25589945

  26. Nazar L, Bastidas J, Coloma R, Zamora M. Prevención y tratamiento de pacientes con náuseas y vómitos postoperatorios. Rev Chil Cir. 2017[acceso: 23/03/2019];69(5):421-28. Disponible en: https://creativecommons.org/licenses/by-nc-nd/4

  27. Subhi M. Alghanem. Optimization of anesthesia antiemetic measures versus combination therapy using dexamethasone or ondansetron for the prevention of postoperative nausea and vomiting. Surg Endosc. 2010;24:353-8.

  28. Swaika S, Pal A, Chatterjee S, Saha D, Dawar N. Ondansetron, ramosetron, orpalonosetron: ¿Whichis a better choice of antiemetic to prevent postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy? Minerva Anestesiol. 2014;80(7):779-84.




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