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2015, Number 1

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Acta Med 2015; 13 (1)

Palonosetron compared with ondansetron in combination therapy with dexamethasone for prevention of postoperative nausea and vomiting in patients at high risk undergoing laparoscopic fundoplication

Alcántara MMRA, Alarcón RJJ, Hernández CC

Language: Spanish
References: 12
Page: 5-8
PDF size: 128.79 Kb.


ABSTRACT

The incidence of postoperative nausea and vomiting in the general population has been estimated to have remained around 20 to 30% in recent years, but it can reach 80% in high risk patients. A wide range of risk factors related to patient variables, anesthetic technique, or surgery have been described. However, risk can be classified by taking only 4 factors into consideration: female gender, nonsmoker, a history of motion sickness or postoperative vomiting, and use of opioids for postoperative analgesia. Antiemetic prophylaxis is not recommended for patients at low risk (only 1 risk factor or none). Considering prophylaxis is recommended for patients at moderate risk (2 risk factors). For patients at high risk (3 or 4 risk factors), prophylaxis should be provided with 4 mg of intravenous ondansetron 30 minutes before ending surgery, 4 mg of intravenous dexamethasone at anesthetic induction, or both. Once preventive measures are taken, therapeutic options are limited and the management of postoperative nausea and vomiting, once established, is difficult.


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