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Ondansetron or droperidol for prophylaxis of nausea and vomiting after intrathecal morphine

Published online by Cambridge University Press:  04 April 2006

A. J. Peixoto
Affiliation:
Hospital de Caridade, Department of Anaesthesiology, Erechim, Brazil
M. F. Celich
Affiliation:
Hospital de Caridade, Department of Anaesthesiology, Erechim, Brazil
L. Zardo
Affiliation:
Hospital de Caridade, Department of Anaesthesiology, Erechim, Brazil
A. J. Peixoto Filho
Affiliation:
Yale University School of Medicine, Section of Nephrology, New Haven Renal Section, VA Connecticut Healthcare System, West Haven, USA
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Summary

Background and objective: There is a controversy regarding the best drug for prevention of nausea and vomiting in patients receiving intrathecal morphine. The aim of this study was to examine efficacy and tolerability of droperidol compared with ondansetron for the prevention of morphine-induced nausea and vomiting. Methods: In a randomized, placebo-controlled trial, 120 women undergoing Caesarean section under spinal anaesthesia with intrathecal morphine 0.1 mg received intravenous ondansetron 4 mg (n = 40), droperidol 1.25 mg (n = 40) or saline (n = 40) immediately after umbilical-cord clamping. Nausea and vomiting were graded according to intensity at 1, 2, 4, 6, 12 and 24 h. Results: Nausea or vomiting occurred in 14 patients (35%) in the placebo group, 4 (10%) in the ondansetron group and 10 (25%) in the droperidol group; the difference between ondansetron and placebo was statistically significant (P = 0.007). Eleven of the 14 placebo patients (27.5%) vomited, compared with none of the 4 ondansetron patients (vs. placebo, P = 0.0004) and 5 of the droperidol patients (vs. placebo, P = 0.18). Three of the 14 placebo patients (7.5%) were nauseous, compared with 4 (10%) receiving ondansetron and 5 (12.5%) receiving droperidol. Conclusions: Ondansetron was effective in reducing the incidence of nausea and vomiting in patients receiving intrathecal morphine for Caesarean section.

Type
Original Article
Copyright
© 2006 European Society of Anaesthesiology

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