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Hosseinipour A, Heydari M, Mohebbinejad A, Mosavat SH, Parkhah M, Hashempur MH. Prophylactic effect of chamomile on post-dural puncture headache in women undergoing elective cesarean section: A randomized, double blind, placebo-controlled clinical trial. Explore (NY) 2024; 20:424-429. [PMID: 37926605 DOI: 10.1016/j.explore.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/13/2023] [Accepted: 10/19/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Post-dural puncture headache (PDPH) is a common complication after spinal anesthesia, affecting patient recovery. This study evaluated the prophylactic effect of topical chamomile ointment on PDPH in women undergoing elective cesarean section. METHODS In a randomized, double-blind, placebo-controlled clinical trial 148 pregnant women were randomized into two parallel groups and received 3cc of the chamomile or the placebo ointment on the forehead of the participants 20 minutes before the start of spinal anesthesia, and then 2 and 4 hours after that. The primary outcomes were the incidence rate of headache, and its severity assessed by a numeric rating scale (NRS), while secondary outcomes included analgesic consumption, frequency of nausea/vomiting, and adverse events. RESULTS Chamomile ointment exhibited significant preventive effects on PDPH incidence compared to placebo. The chamomile group demonstrated lower rates of PDPH at 6 hours (3.5% vs. 7.18%, p = 0.021) and 12 hours (7.6% vs. 20%, p = 0.028) after spinal anesthesia. Analgesic consumption, frequency of nausea/vomiting, and adverse events were comparable between the groups. CONCLUSION Topical chamomile ointment demonstrated significant preventive effects on PDPH incidence compared to placebo. Chamomile ointment could be a promising adjunctive approach to prevent PDPH, enhancing patient comfort and potentially reducing the need for analgesics. Further investigation is needed to explore its mechanisms and broader applications.
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Affiliation(s)
| | - Mojtaba Heydari
- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Seyed Hamdollah Mosavat
- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Parkhah
- Department of Anesthesiology, Kowsar Hospital, Fars Heart Foundation, Shiraz, Iran
| | - Mohammad Hashem Hashempur
- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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Karami A, Ramadani E, Banifatemi M, Asmarian N, Fattahi Saravi Z. Comparison of Nausea and Vomiting Incidence After Laparoscopic Cholecystectomy With Pretreatment With Haloperidol and Ondansetron: A Randomization Clinical Trial Study. Surg Laparosc Endosc Percutan Tech 2024; 34:118-123. [PMID: 38450649 DOI: 10.1097/sle.0000000000001269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/20/2023] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Nausea and vomiting after surgery are the most common complications. Therefore, we performed this study to compare the effect of ondansetron and haloperidol on nausea and vomiting after laparoscopic cholecystectomy. PATIENTS AND METHODS In this randomized clinical trial, 60 patients candidates for elective laparoscopic cholecystectomy were allocated to haloperidol (0.05 mg/kg, n = 30) and ondansetron (0.15 mg/kg, n = 30) groups. An Ocular Analog Scale was used to assess postoperative nausea and vomiting. Every 15 minutes in the recovery room, heart rate and blood pressure were measured up to 6 hours after surgery. In addition, patient satisfaction was assessed postoperatively. RESULTS Haloperidol and ondansetron have the same effect on postoperative nausea and vomiting in the recovery room and ward. It was found that the trend of Visual Analog Scale variable changes in the recovery room was similar in the haloperidol and ondansetron group ( P = 0.58); it was also true for the ward ( P = 0.79). Comparing the length of stay in a recovery room in the 2 groups was not statistically significant ( P = 0.19). In addition, the 2 groups did not differ in satisfaction postoperatively ( P = 0.82). CONCLUSION Haloperidol and ondansetron had an equal effect on reducing nausea and vomiting in the recovery room and ward after laparoscopic cholecystectomy. Patient satisfaction and length of stay in the recovery room did not differ between groups.
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Affiliation(s)
- Ali Karami
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Zhao G, Song G, Liu J. Efficacy of pharmacological therapies for preventing post-dural puncture headaches in obstetric patients: a Bayesian network meta-analysis of randomized controlled trials. BMC Pregnancy Childbirth 2023; 23:215. [PMID: 36991366 DOI: 10.1186/s12884-023-05531-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/20/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Post-dural puncture headache (PDPH) is a major complication of neuraxial anesthesia. PDPH usually occurs after Caesarean section in obstetric patients. The efficacy of prophylactic pharmacological therapies remains controversial. METHODS Seven pharmacological therapies (aminophylline (AMP), dexamethasone, gabapentin/pregabalin (GBP/PGB), hydrocortisone, magnesium, ondansetron (OND), and propofol (PPF)), were studied in this Bayesian network meta-analysis. The primary outcome was the cumulative incidence of PDPH within 7 days. Secondary outcomes included the incidence of PDPH at 24 and 48 h postoperatively, the severity of headache in PDPH patients (24, 48, and 72 h postoperatively), and postoperative nausea and vomiting (PONV). RESULTS Twenty-two randomized controlled trials with 4,921 pregnant women (2,723 parturients received prophylactic pharmacological therapies) were included. The analyses demonstrated that PPF, OND, and AMP were efficient in decreasing the cumulative incidence of PDPH during the follow-up period compared to the placebo group (OR = 0.19, 95% CI: 0.05 to 0.70; OR = 0.37, 95% CI: 0.16 to 0.87; OR = 0.40, 95% CI: 0.18 to 0.84, respectively). PPF and OND had the lower incidence of PONV compared to the placebo group (OR = 0.07, 95% CI: 0.01 to 0.30; and OR = 0.12, 95% CI: 0.02 to 0.63). No significant difference in other outcomes was found among different therapies. CONCLUSIONS Based on available data, PPF, OND, and AMP may have better efficacy in decreasing the incidence of PDPH compared to the placebo group. No significant side effects were revealed. Better-designed studies are requested to verify these conclusions.
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Affiliation(s)
- Ge Zhao
- Department of Obstetrics, The First Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning Province, China
| | - Guang Song
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jing Liu
- Department of Obstetrics, The First Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning Province, China.
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Volkova YV, Mykhnevych KG, Ponomaryov VI, Dmytriiev DV, Dmytriiev KD, Lyzohub KI, Potapov SM. 5-HT3 SEROTONIN RECEPTOR BLOCKERS FOR INTENSIVE THERAPY OF TRAUMATIC DISEASE IN PATIENTS WITH MULTIPLE TRAUMA. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:2683-2686. [PMID: 36591754 DOI: 10.36740/wlek202211123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The aim: To find the most rational choice of drugs that have anti-emetic effect in patients with polytrauma in acute and early periods. PATIENTS AND METHODS Materials and methods: We examined 82 patients with polytrauma, 62 men and 20 women. The age of patients ranged from 19 to 50 years. Patients were divided into the main and control group with 36 and 46 people respectively, who did not differ significantly by sex, age, anthropometric data, the nature and severity of injuries, and the time from injury to admission to hospital. RESULTS Results: Full antiemetic effect was achieved in 72.4% of patients, where metoclopramide was used. Сomplete antiemetic effect was achieved in 96.3% of patients, where sturgeon was used. Decrease of peristaltic activity does not increase postoperative intestinal paresis, and also prevents irritable bowel syndrome and diarrhea caused by dysbacteriosis on the background of antibiotic therapy. Anxiolytic effect without sedative effect and impairment of motor coordination, decrease of the somatic and psychopathological symptoms intensity in alcohol-toxic withdrawal syndrome contributes to the correct interpretation of the traumatic disease. CONCLUSION Conclusions: Use of drugs with antiemetic effect is an important part of the complex of traumatic disease treatment in patients with polytrauma. The use of osetron is rational in patients with polytrauma with cranio-abdominal injuries.
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Affiliation(s)
| | | | - Volodymyr I Ponomaryov
- EDUCATIONAL AND SCIENTIFIC MEDICAL INSTITUTE OF THE NATIONAL TECHNICAL UNIVERSITY «KHARKIV POLYTECHNIC INSTITUTE», KHARKIV, UKRAINE
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Li C, Cui W, Song P, Liu W, Wang X, Yang Q. Effect of ondansetron for preventing postoperative nausea and vomiting after breast cancer surgery. Am J Transl Res 2022; 14:6689-6695. [PMID: 36247242 PMCID: PMC9556477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 08/09/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To evaluate the preventive effect of preoperative administration of ondansetron on postoperative nausea and vomiting (PONV) in patients receiving breast cancer surgery. METHODS Data from 225 patients who received modified radical mastectomy from January 2019 to December 2020 were retrospectively reviewed. The patients were divided into an ondansetron group and a control group according to whether they received preoperative ondansetron or not. The incidence of PONV, visual analog scale (VAS) score, the rescue analgesics use and rescue antiemetic use, as well as the patient satisfaction degree about their PONV were compared between the two groups. RESULTS The ondansetron group showed lower total incidence of PONV, lower VAS score at 6 h post-operation as well as less rescue antiemetic use than the control group (P<0.05). Patients in the ondansetron group were more satisfied with their PONV condition than those in the control group (P<0.05). CONCLUSION Preoperative administration of ondansetron can prevent PONV and relieve pain 2-24 hours after breast cancer surgery.
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Affiliation(s)
- Chunlei Li
- Department of Anesthesiology, Cangzhou Central HospitalCangzhou 061000, Hebei, China
| | - Wenbin Cui
- Department of Anesthesiology, Cangzhou Central HospitalCangzhou 061000, Hebei, China
| | - Panpan Song
- Department of Anesthesiology, Cangzhou Central HospitalCangzhou 061000, Hebei, China
| | - Wang Liu
- Department of Anesthesiology, Children’s Ward of Cangzhou Central HospitalCangzhou 061000, Hebei, China
| | - Xiaodong Wang
- Department of Anesthesiology, Cangzhou Integrated Traditional Chinese and Western Medicine HospitalCangzhou 061000, Hebei, China
| | - Qiang Yang
- Department of Anesthesiology, Cangzhou Central HospitalCangzhou 061000, Hebei, China
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Griffiths JD, Gyte GM, Popham PA, Williams K, Paranjothy S, Broughton HK, Brown HC, Thomas J. Interventions for preventing nausea and vomiting in women undergoing regional anaesthesia for caesarean section. Cochrane Database Syst Rev 2021; 5:CD007579. [PMID: 34002866 PMCID: PMC8130052 DOI: 10.1002/14651858.cd007579.pub3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Nausea and vomiting are distressing symptoms which are experienced commonly during caesarean section under regional anaesthesia and in the postoperative period. OBJECTIVES: To assess the efficacy of pharmacological and non-pharmacological interventions versus placebo or no intervention given prophylactically to prevent nausea and vomiting in women undergoing regional anaesthesia for caesarean section. SEARCH METHODS For this update, we searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) (16 April 2020), and reference lists of retrieved studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) of studies and conference abstracts, and excluded quasi-RCTs and cross-over studies. DATA COLLECTION AND ANALYSIS Review authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. Our primary outcomes are intraoperative and postoperative nausea and vomiting. Data entry was checked. Two review authors independently assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS Eighty-four studies (involving 10,990 women) met our inclusion criteria. Sixty-nine studies, involving 8928 women, contributed data. Most studies involved women undergoing elective caesarean section. Many studies were small with unclear risk of bias and sometimes few events. The overall certainty of the evidence assessed using GRADE was moderate to very low. 5-HT3 antagonists: We found intraoperative nausea may be reduced by 5-HT3 antagonists (average risk ratio (aRR) 0.55, 95% confidence interval (CI) 0.42 to 0.71, 12 studies, 1419 women, low-certainty evidence). There may be a reduction in intraoperative vomiting but the evidence is very uncertain (aRR 0.46, 95% CI 0.29 to 0.73, 11 studies, 1414 women, very low-certainty evidence). There is probably a reduction in postoperative nausea (aRR 0.40, 95% CI 0.30 to 0.54, 10 studies, 1340 women, moderate-certainty evidence), and these drugs may show a reduction in postoperative vomiting (aRR 0.47, 95% CI 0.31 to 0.69, 10 studies, 1450 women, low-certainty evidence). Dopamine antagonists: We found dopamine antagonists may reduce intraoperative nausea but the evidence is very uncertain (aRR 0.38, 95% CI 0.27 to 0.52, 15 studies, 1180 women, very low-certainty evidence). Dopamine antagonists may reduce intraoperative vomiting (aRR 0.41, 95% CI 0.28 to 0.60, 12 studies, 942 women, low-certainty evidence) and postoperative nausea (aRR 0.61, 95% CI 0.48 to 0.79, 7 studies, 601 women, low-certainty evidence). We are uncertain if dopamine antagonists reduce postoperative vomiting (aRR 0.63, 95% CI 0.44 to 0.92, 9 studies, 860 women, very low-certainty evidence). Corticosteroids (steroids): We are uncertain if intraoperative nausea is reduced by corticosteroids (aRR 0.56, 95% CI 0.37 to 0.83, 6 studies, 609 women, very low-certainty evidence) similarly for intraoperative vomiting (aRR 0.52, 95% CI 0.31 to 0.87, 6 studies, 609 women, very low-certainty evidence). Corticosteroids probably reduce postoperative nausea (aRR 0.59, 95% CI 0.49 to 0.73, 6 studies, 733 women, moderate-certainty evidence), and may reduce postoperative vomiting (aRR 0.68, 95% CI 0.49 to 0.95, 7 studies, 793 women, low-certainty evidence). Antihistamines: Antihistamines may have little to no effect on intraoperative nausea (RR 0.99, 95% CI 0.47 to 2.11, 1 study, 149 women, very low-certainty evidence) or intraoperative vomiting (no events in the one study of 149 women). Antihistamines may reduce postoperative nausea (aRR 0.44, 95% CI 0.30 to 0.64, 4 studies, 514 women, low-certainty evidence), however, we are uncertain whether antihistamines reduce postoperative vomiting (average RR 0.48, 95% CI 0.29 to 0.81, 3 studies, 333 women, very low-certainty evidence). Anticholinergics: Anticholinergics may reduce intraoperative nausea (aRR 0.67, 95% CI 0.51 to 0.87, 4 studies, 453 women, low-certainty evidence) but may have little to no effect on intraoperative vomiting (aRR 0.79, 95% CI 0.40 to 1.54, 4 studies; 453 women, very low-certainty evidence). No studies looked at anticholinergics in postoperative nausea, but they may reduce postoperative vomiting (aRR 0.55, 95% CI 0.41 to 0.74, 1 study, 161 women, low-certainty evidence). Sedatives: We found that sedatives probably reduce intraoperative nausea (aRR 0.65, 95% CI 0.51 to 0.82, 8 studies, 593 women, moderate-certainty evidence) and intraoperative vomiting (aRR 0.35, 95% CI 0.24 to 0.52, 8 studies, 593 women, moderate-certainty evidence). However, we are uncertain whether sedatives reduce postoperative nausea (aRR 0.25, 95% CI 0.09 to 0.71, 2 studies, 145 women, very low-certainty evidence) and they may reduce postoperative vomiting (aRR 0.09, 95% CI 0.03 to 0.28, 2 studies, 145 women, low-certainty evidence). Opioid antagonists: There were no studies assessing intraoperative nausea or vomiting. Opioid antagonists may result in little or no difference to the number of women having postoperative nausea (aRR 0.75, 95% CI 0.39 to 1.45, 1 study, 120 women, low-certainty evidence) or postoperative vomiting (aRR 1.25, 95% CI 0.35 to 4.43, 1 study, 120 women, low-certainty evidence). Acupressure: It is uncertain whether acupressure/acupuncture reduces intraoperative nausea (aRR 0.55, 95% CI 0.41 to 0.74, 9 studies, 1221 women, very low-certainty evidence). Acupressure may reduce intraoperative vomiting (aRR 0.52, 95% CI 0.33 to 0.80, 9 studies, 1221 women, low-certainty evidence) but it is uncertain whether it reduces postoperative nausea (aRR 0.46, 95% CI 0.27 to 0.75, 7 studies, 1069 women, very low-certainty evidence) or postoperative vomiting (aRR 0.52, 95% CI 0.34 to 0.79, 7 studies, 1069 women, very low-certainty evidence). Ginger: It is uncertain whether ginger makes any difference to the number of women having intraoperative nausea (aRR 0.66, 95% CI 0.36 to 1.21, 2 studies, 331 women, very low-certainty evidence), intraoperative vomiting (aRR 0.62, 95% CI 0.38 to 1.00, 2 studies, 331 women, very low-certainty evidence), postoperative nausea (aRR 0.63, 95% CI 0.22 to 1.77, 1 study, 92 women, very low-certainty evidence) and postoperative vomiting (aRR 0.20, 95% CI 0.02 to 1.65, 1 study, 92 women, very low-certainty evidence). Few studies assessed our secondary outcomes including adverse effects or women's views. AUTHORS' CONCLUSIONS This review indicates that 5-HT3 antagonists, dopamine antagonists, corticosteroids, sedatives and acupressure probably or possibly have efficacy in reducing nausea and vomiting in women undergoing regional anaesthesia for caesarean section. However the certainty of evidence varied widely and was generally low. Future research is needed to assess side effects of treatment, women's views and to compare the efficacy of combinations of different medications.
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Affiliation(s)
- James D Griffiths
- Department of Anaesthesia, Royal Women's Hospital, Parkville, Australia
| | - Gillian Ml Gyte
- Cochrane Pregnancy and Childbirth Group, Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
| | | | - Kacey Williams
- Department of Anaesthesia, Monash Medical Centre, Monash Health, Clayton, Australia
| | - Shantini Paranjothy
- Cochrane Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK
| | - Hannah K Broughton
- Cochrane Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK
| | - Heather C Brown
- Department of Obstetrics and Gynaecology, Royal Sussex County Hospital, Brighton, UK
| | - Jane Thomas
- C/o Cochrane Pregnancy and Childbirth Group, Department of Women's and Children's Health, The University of Liverpool, Liverpool, UK
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Elvir-Lazo OL, White PF, Yumul R, Cruz Eng H. Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review. F1000Res 2020; 9. [PMID: 32913634 PMCID: PMC7429924 DOI: 10.12688/f1000research.21832.1] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2020] [Indexed: 01/10/2023] Open
Abstract
Postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) remain common and distressing complications following surgery. The routine use of opioid analgesics for perioperative pain management is a major contributing factor to both PONV and PDNV after surgery. PONV and PDNV can delay discharge from the hospital or surgicenter, delay the return to normal activities of daily living after discharge home, and increase medical costs. The high incidence of PONV and PDNV has persisted despite the introduction of many new antiemetic drugs (and more aggressive use of antiemetic prophylaxis) over the last two decades as a result of growth in minimally invasive ambulatory surgery and the increased emphasis on earlier mobilization and discharge after both minor and major surgical procedures (e.g. enhanced recovery protocols). Pharmacologic management of PONV should be tailored to the patient’s risk level using the validated PONV and PDNV risk-scoring systems to encourage cost-effective practices and minimize the potential for adverse side effects due to drug interactions in the perioperative period. A combination of prophylactic antiemetic drugs with different mechanisms of action should be administered to patients with moderate to high risk of developing PONV. In addition to utilizing prophylactic antiemetic drugs, the management of perioperative pain using opioid-sparing multimodal analgesic techniques is critically important for achieving an enhanced recovery after surgery. In conclusion, the utilization of strategies to reduce the baseline risk of PONV (e.g. adequate hydration and the use of nonpharmacologic antiemetic and opioid-sparing analgesic techniques) and implementing multimodal antiemetic and analgesic regimens will reduce the likelihood of patients developing PONV and PDNV after surgery.
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Affiliation(s)
| | - Paul F White
- Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.,The White Mountain Institute, The Sea Ranch, Sonoma, CA, 95497, USA.,Instituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy
| | - Roya Yumul
- Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.,David Geffen School of Medicine-UCLA, Charles R. Drew University of Medicine and Science, Los Angeles, CA, 90095, USA
| | - Hillenn Cruz Eng
- Department of Anesthesiology, PennState Hershey Medical Center, Hershey, PA, 17033, USA
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Patel R, Urits I, Orhurhu V, Orhurhu MS, Peck J, Ohuabunwa E, Sikorski A, Mehrabani A, Manchikanti L, Kaye AD, Kaye RJ, Helmstetter JA, Viswanath O. A Comprehensive Update on the Treatment and Management of Postdural Puncture Headache. Curr Pain Headache Rep 2020; 24:24. [DOI: 10.1007/s11916-020-00860-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Salajegheh S, Kuhestani S, Kermani MS, Taheri O, Bafghi NN. Comparison of Ondansetron and Granisetron Effects for Prevention of Nausea and Vomiting Following Strabismus Surgery. Open Access Maced J Med Sci 2019; 7:3195-3200. [PMID: 31949515 PMCID: PMC6953944 DOI: 10.3889/oamjms.2019.795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 08/10/2019] [Accepted: 08/11/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Postoperative nausea and vomiting (PONV) is a common complaint after strabismus surgery that leads to unpleasantness, increased hospitalisation time and increased costs. In severe cases, it can lead to dehydration, electrolyte disturbances, aspiration, pneumonia, and even sutures opening. AIM This study was conducted to compare the effects of both ondansetron and granisetron on the reduction of PONV after strabismus surgery. METHODS This randomised, and the double-blind clinical study was conducted on patients with ASA I and II undergoing strabismus surgery with age over 3 years old in Shafa Hospital, Kerman University of Medical Sciences during 2017 under general anaesthesia. Patients with inclusion criteria were randomly assigned to one of three groups including Ondansetron (A), Granisetron (B) and control group (C). Matching cases and controls on drugs were fully completed. Furthermore, 100 μg/kg of Ondansetron was intravenously injected, followed by injection of 40 μg/kg Granisetron for another intervention group. All patients underwent the same anaesthetic procedure and intravenous injection of drugs during anaesthesia induction. The severity of nausea and vomiting in recovery, 6 and 18 hours after the operation were verified according to the Verbal Rating Scale (VRS). Our data were analysed by Chi-square, ANOVA and TUKEY tests via SPSS version 18. RESULTS There was no significant difference between the three groups in terms of age and sex. The incidence of postoperative nausea in recovery among three groups of A, B and C was determined to be 15, 7.5 and 37.5%, respectively. No significant difference was found between the two groups A and B (P = 0.68), although there was a significant difference between these two groups and group C (P < 0.05). The incidence of nausea at 6 hours after surgery in groups A, B and C was recorded as 40, 15 and 65% respectively, indicating that the incidence of nausea in group B was significantly lower than the other two groups, while showed a significant difference with group A (P = 0.039) and group C (P < 0.05). Also, the incident of nausea between groups was not statistically significant 18 hours after surgery (P < 0.05). Additionally, no significant difference was found in different groups in terms of vomiting incidence in recovery, 6 and 18 hours after surgery (P < 0.05). CONCLUSION Our study suggests that Granisetron is more effective in preventing PONV during 6 hours after the surgery in comparison with Ondansetron which makes it a favourable alternative for preventing PONV.
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Affiliation(s)
- Shirin Salajegheh
- Department of Anesthesiology, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Soodeh Kuhestani
- Department of Anesthesiology, Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Omid Taheri
- Department of Anesthesiology, Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Naeimeh Naeimi Bafghi
- Department of Anesthesiology, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
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10
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Chen X, Qin Y, Li S, Lei H, Wu X, Shu L. Efficacy of 5-HT3 receptor antagonists (ondansetron) vs dopamine receptor antagonists (droperidol) for preventing postoperative nausea, vomiting and headache: a meta-analysis. Pteridines 2019. [DOI: 10.1515/pteridines-2019-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Objective To investigate the effects of 5-hydroxytryptamine 3 receptor antagonists (ondansetron [OND]) versus dopamine receptor antagonists (droperidol [DRO]) in the prevention of postoperative nausea, vomiting (PONV) and headache by pooling data from open published studies. Methods Performed systematic electronic searches of PubMed, Embase, Google scholar and CNKI, to identify open-published prospective randomized controlled trials (RCTs) relevant to the comparison of OND versus DRO for preventing PONV and headache to be included in the present study. The pooled PONV, headache, dizziness and drowsiness were calculated based on the original data of each included study. The pooled data was presented with risk ratio (RR) and 95% confidence interval (95%CI). Results Thirteen prospective randomized clinical trials were included in this meta-analysis. The pooled PONV, post-operative nausea (PON) and positive operative vomiting (POV) were 0.67 (95%CI:0.48-0.93, p<0.05), 0.88 (95%CI:0.67-1.14, p>0.05) and 0.56 (95%CI:0.39-0.82,p<0.05) respectively for OND vs. DRO. And the overall pooled positive operative nausea and vomiting was 0.71(95%CI:0.60-0.86) by fixed effects model for OND vs. DRO. The pooled risk of postoperative headache, dizziness and drowsiness were 4.33 (95%CI:0.76-24.69, p>0.05), 0.63 (95%CI:0.21-1.87, p>0.05) and 0.48(0.28-0.81,p<0.05) respectively by fixed effect model for OND vs. DRO. Conclusion The post-operative nausea, vomiting and dizziness risks were significant decreased for patients receiving OND compared to patients receiving DRO.
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Affiliation(s)
- Xiaoyun Chen
- Department of Anesthesiology , Wuming Hospital of Guangxi Medical University , Guangxi 530199 PR China
| | - Yinying Qin
- Department of Anesthesiology , Wuming Hospital of Guangxi Medical University , Guangxi 530199 PR China
| | - Siying Li
- Department of Anesthesiology , Wuming Hospital of Guangxi Medical University , Guangxi 530199 PR China
| | - Heshou Lei
- Department of Anesthesiology , Wuming Hospital of Guangxi Medical University , Guangxi 530199 PR China
| | - Xiaoyun Wu
- Department of Anesthesiology , Wuming Hospital of Guangxi Medical University , Guangxi 530199 PR China
| | - LiPei Shu
- Department of Anesthesiology , The First Affiliated Hospital Of Guanxi Medical University , Guangxi 530021 PR China
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