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Multimodal prophylaxis of postoperative nausea and vomiting in day-case anaesthesia: A-47

Villazala, R.; Zaballos, M.; Varela, A.; Agustí, S.; Gago, S.; Jimenez, C.; Navia, J.

European Journal of Anaesthesiology: May 2005 - Volume 22 - Issue - p 13
Ambulatory Anaesthesia
Free

Department of Anaesthesia and Intensive Care, Gregorio Marañon University Hospital, Madrid, Spain

Background and Goals: Incidence of postoperative nausea and vomiting (PONV) is still in the range of 25-30%. Risk scores for predicting them and a multimodal prophylaxis have been proposed to reduce the overall incidence (1). We compare the effectiveness of combined therapy in presence of sevoflurane or propofol anaesthesia in ambulatory surgery.

Materials and Methods: 330 patients with low to moderate risk factors (RF) were randomly assigned to sevoflurane or total intravenous anaesthesia (TIVA). The antiemetic regimen was zero RF - no prophylaxis, one RF - 1 antiemetic, two RF - 2 antiemetics, three RF - 3 antiemetics. The drugs used were: ondansetron 4mg, droperidol 0.625 mg and dexamethasone 8mg. Statistical tests used was t-Student and Χ2. A p value <0.05 was considered significant.

Results and Discussions: There were no differences in RF between groups. There was a higher proportion of maxillofacial surgery on sevoflurane group (p < 0.005).

Table

Table

Conclusion: The multimodal approach to PONV is associated with a higher proportion of patients with a complete response in TIVA with propofol than sevoflurane anaesthesia.

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Reference:

1 Habib AS, Gan TJ. Can Anesth 2004; 51:326-341
© 2005 European Society of Anaesthesiology