Scopolamine for prevention of postoperative nausea in gynecologic laparoscopy, a randomized trial

Abstract

Study objective: We sought to estimate effectiveness of transdermal scopolamine to prevent postoperative nausea and vomiting after gynecologic laparoscopy.

Design: Patients were randomized to receive preoperative transdermal scopolamine or placebo. Main outcome measure was incidence of nausea during the first 24 hours postoperatively. Wilcoxon rank sum, Student t, chi2, and Fischer exact tests were used for data analysis (Canadian Task Force classification IA).

Setting: Academic teaching hospital.

Patients: A total of 48 patients undergoing gynecologic laparoscopy were studied.

Interventions: Randomized administration of transdermal Scopolamine or placebo in patients having gynecologic laparoscopic surgery.

Measurements and main results: Patients in the scopolamine group had significantly less incidence of nausea (20.8% vs 62.5%, p = .003) and vomiting (8.3% vs 37.5%, p = .016) during the first 24 hours after surgery. Number needed to treat was 3 (95% CI 1.5, 6.1) for nausea and 4 (95% CI 1.9, 14.6) for vomiting. Symptoms of visual disturbance and dry mouth were more common in the scopolamine group.

Conclusion: Scopolamine patch significantly reduces incidence and severity of nausea and vomiting in the first 24 hours after gynecologic laparoscopic surgery.