Comparative study of anti-emetics and their association, in the prevention of postoperative nausea and vomiting in patients undergoing gynecologic surgeries

Abstract

Background and objectives: Prophylaxis of postoperative nausea and vomiting has been the subject of several studies. The objective of the present study was to compare anti-emetics, and their association, in the prevention of postoperative nausea and vomiting.

Methods: Seventy patients, ASA I and II, underwent epidural block associated with general anesthesia for gynecologic surgeries. Patients in the Metochlopramide Group (MG) received 20 mg of the drug; the Dexamethasone Group (DeG) received 8 mg; the Droperidol Group (DrG) received 1.25 mg; the Ondansetron Group (OG) received 8 mg; the Dexamethasone-Ondansetron Group (DeOG) received 8 mg and 4 mg, respectively; the Droperidol-Ondansetron Group (DrOG) received 1.25 mg and 4 mg, respectively; the Dexamethasone-Droperidol-Ondansetron Group (DeDrOG) received 8 mg, 0.625 mg, and 4 mg. The presence of nausea and vomiting was evaluated at 6, 12, 24, and 36 hours after the end of the surgery.

Results: The total incidence of episodes of nausea per group is as follows: 4 in DeDrOG, 6 in OG, 6 in DrOG, 11 in DeG, 11 in DeOG, 18 in MG, and 22 in DrG. The Chi-square and Fisher exact tests indicated statistically significant differences between DrG and DeG, DOG, DrOG, DeOG, and DeDrOG; between MG and OG, DrOG, and DeDrOG; and between DeOG and DeDrOG. And the incidence of vomiting was: 3 in OG, 3 in DeDrOG, 6 in DrOG, 7 in DeG, 7 in DeOG, and 10 in DrG, and 13 in G. There was a statistically significant difference between DrG and OG and DeDrOG; and between MG and OG and DeDrOG.

Conclusions: The association dexamethasone-droperidol-ondansetron and ondansetron alone were more effective in the prophylaxis of nausea and vomiting.