A comparison of ranitidine, droperidol or placebo in the prevention of nausea and vomiting after hysterectomy

Abstract

Purpose: The effect of ranitidine on postoperative nausea and vomiting (PONV) was assessed when compared with droperidol and with placebo.

Methods: Three groups of sixty patients were studied in a double-blind randomized manner. The first group received ranitidine tablets 300 mg on the night before and on the following morning, one hour before induction of anaesthesia. Thirty minutes before surgery ended they were given isotonic saline 0.3 ml iv. The second group had placebo in place of ranitidine while before the operation ended, droperidol 0.75 mg (0.3 ml) was injected. The third group received placebos rather than the study drugs. The immediate two-hour postoperative recovery room period and that on the ward were evaluated until the next morning. PONV information was gathered from complaints by the patients and from direct questioning by the nursing staff. Droperidol 0.75 mg iv served as the "rescue drug."

Results: Less PONV occurred in patients who received anti-emetics than those given placebo: recovery room, P = 0.0109; ward, P = 0.007. Droperidol better suppressed PONV in the recovery room (P = 0.005) with no statistical significance seen between ranitidine and placebo. On the ward, both anti-emetics were more effective than placebo (ranitidine, P = 0.01; droperidol, P = 0.003). "Rescue drug" requirements throughout the study periods were not statistically significant.

Conclusion: Although both anti-emetics were associated with a smaller incidence of PONV than was placebo, droperidol was superior to ranitidine in preventing sickness during the immediate postoperative period. The need for the "rescue drug" was similar in all groups.