05 06

Research paper discussion of results

Is ondansetron as effective as droperidol in prevention of postoperative nausea and vomiting?

Pamela J. Mencken RN BSN, Debra J. Blalock RN BSN, Wayne R. Miller PharmD, Michael P. Davis CRNA MS, Peter D. Hamm CRNA MS

The incidence of postoperative nausea and vomiting (PONV) remains 20 to 30% despite the availability of newer antiemetics such as ondansetron and other 5-HT3 antagonists. The cost of these drugs often results in the use of less expensive antiemetics such as droperidol. Common practice is to treat nausea and vomiting only after it has occurred. The few studies which have examined prophylaxis of PONV have had small sample sizes (Grond et al. Anesth Analg 1995; 81:603-7). The purpose of this study was to determine if there was a difference between ondansetron and droperidol in preventing PONV.

After institutional review board approval and with written informed consent, a controlled, double-blinded study was conducted with 105 male and female patients, ASA status I to III, randomly assigned into 2 groups with the aid of a computer-generated table of random numbers. All patients underwent elective intra abdominal procedures. Exclusion criteria included weight exceeding body mass index of 30 kg/m2, nasogastric tube prior to induction, history of motion sickness or postoperative nausea and vomiting, antiemetic use within 24 hours of surgery, pregnancy, and subjects with contraindications to either study drug. All patients received a standardized induction with d-tubocurarine, succinylcholine, thiopental sodium, and fentanyl (2 to 20 mcg/kg). Anesthesia was maintained with isoflurane or desflurane in oxygen. Five minutes prior to induction of general anesthesia, patients received either ondansetron 4 mg intravenously (IV), or droperidol 1.25 mg IV. Syringes of identical appearence containing either agent were prepared by the satellite pharmacist, who alone was aware of group assignment. All data was collected by the principal investigators in a blinded fashion, rating PONV using a visual analogue scale of 0 to 10.

Five patients were eliminated from the study; 1 was lost to follow up, 2 patients exceeded the surgical time limit of 4 hours, 1 patient did not receive general anesthesia, and 1 patient did not receive the general anesthesia protocol as described. The groups did not differ significantly in age, weight, height, ASA status, or doses of intraoperative drugs. Patients in the droperidol group showed a trend (P=.078) toward less PONV (0.37 ╠ 0.038; mean ╠ one standard deviation) than the ondansetron group (1.0 ╠ 2.362). The patients who received droperidol had a trend towards a higher incidence of post discharge antiemetic use than the patients in the ondansetron group (P=0.091). Patients in the droperidol group did not spend a longer time in PACU (87 ╠ 62 min) as compared to the ondansetron group (102 ╠ 62 min; P=.443). Pretreatment with droperidol resulted in an overall 11.8% incidence of PONV, compared to 26.5% incidence in the ondansetron group (P=.07).

In conclusion, pretreatment with droperidol reduced the incidence of PONV in this sample, and patients did not stay longer in the PACU with the droperidol treatment. Further study is needed to determine if a combination of droperidol and ondansetron would decrease PONV more effectively than either agent used alone.

research paper discussion of results

Comments

  1. Pedoborozin

    Turned in the research paper

  2. Suyezig

    Have to finish my research paper by 4:15 and haven"t even started

  3. Lubokoxapap

    Ive been doing the most just so my teacher doesnt find out i copy and pasted my whole research paper holy shit lol

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