[Prevention of postoperative nausea and vomiting after hysterectomy with oral dolasetron, intravenous dehydrobenzperidol or a combination of both substances]

Abstract

Objective: PONV is a frequent postoperative complication. The aim of this study was to assess the efficacy of oral dolasetron in comparison to intravenous droperidol (DHB) and to a combination of both drugs for prophylaxis of PONV.

Methods: 80 patients (ASA I-III) were randomly allocated to one of four groups and received the following medication: group A: 50 mg dolasetron was given orally 45-60 minutes before anaesthesia was induced, group B: 2.5 mg i.v. DHB + placebo p.o. was administered while inducing anaesthesia (positive control group), group C: 50 mg dolasetron was given 45-60 minutes before anaesthesia was induced and 2.5 mg i.v. DHB was given while inducing anaesthesia, group D: placebo tablet was administered 45-60 minutes before anaesthesia was induced (negative control group). PONV was assessed using a 5-point score: 0 = no symptoms, 1 = nausea, 2 = retching, 3 = vomiting, 4 = multiple vomiting. Metoclopramid was given as antiemetic if a patient reached two or more score points.

Results: PONV scores were significantly lower in group A and C (p < 0.001) compared to the control group. Patients treated with DHB showed a significantly lower PONV score in comparison to the placebo treated patients (p < 0.05). Between the groups A, B and C we found no significantly different PONV scores. Postoperative consumption of metoclopramid was significantly lower in the groups A (2.4 +/- 5.2 mg) and C (1.0 +/- 3.1 mg) than in the placebo group (6.0 +/- 6.8 mg), whereas between group B (3.0 +/- 5.7 mg) and D we found no significant differences.

Conclusions: Single dose of oral dolasetron and single dose of intravenous DHB reduced PONV effectively, in patients undergoing gynaecologic surgery. A combination of dolasetron and DHB has no better effect than a single dose of oral dolasetron. Contrary to DHB the application of dolasetron decreased the postoperative antiemetic requirement significantly.