Prophylactic antiemetics for laparoscopic cholecystectomy: a comparison of perphenazine, droperidol plus ondansetron, and droperidol plus metoclopramide

Abstract

Study objective: To compare the prophylactic administration of ondansetron plus droperidol, droperidol plus metoclopramide, and perphenazine to determine effects on postoperative nausea, vomiting, and sedation after laparoscopic cholecystectomy.

Design: Prospective, randomized, double-blind study.

Setting: University medical center.

Patients: 212 ASA physical status I and II adults presenting for laparoscopic cholecystectomy.

Interventions: Patients were randomly assigned to receive one of three prophylactic antiemetic drug combinations: ondansetron 4 mg plus droperidol 0.625 mg (Group OD), droperidol 0.625 mg plus metoclopramide 10 mg (Group DM), or perphenazine 5 mg (Group P). Study drugs were administered intravenously after induction of general anesthesia.

Measurements and main results: The groups were similar with respect to gender, age, weight, duration of surgery, numbers of patients receiving intraoperative atropine or ephedrine, number admitted overnight, and time to discharge home. Patients in Group P used lower total doses of opioids than did patients in Group OD. There were no significant differences in postoperative nausea, pain, or sedation scores, in numbers of patients requiring antiemetics (Group OD, 13 of 66; Group DM, 15 of 66; Group P, 14 of 68), or in numbers of patients vomiting, either in hospital or during the first postoperative day.

Conclusions: These three drug regimens are equivalent for antiemetic prophylaxis before laparoscopic cholecystectomy.