The Effects of a Preoperative Transdermal Scopolamine on the Postoperative Nausea and Vomiting after Outpatient Conization. |
Hyun Joo Ahn |
Department of Anesthesiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. mallang@hanmir.com |
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Abstract |
BACKGROUND Postoperative nausea and vomiting (PONV) is one of the major causes that delays patients discharge in outpatient surgery. A transdermal scopolamine patch (TSP) is effective in preventing PONV and covers PONV for a long duration (72 hr) even after discharge. Therefore, we evaluated PONV using TSP on outpatient conization cases. METHODS Forty four patients scheduled for a conization due to cervical intraepithelial neoplasm were randomly divided into two groups. A Band-Aid(R) -like patch containing either scopolamine (22 patients in TSP group) or a placebo (22 patient in placebo group) was placed either mastoid area at the night before surgery. Anesthesia was induced with fentanyl (50 or 100ng) and thiopental (375 mg/kg) and maintained with enflurane (1 vol%) and nitrous oxide (60%) in oxygen. The study was performed in a double-blind placebo-controlled manner. RESULTS Incidences of PONV (TSP group: 4.5%, placebo group: 18.2%), requirements of antiemetics (TSP group: 0%, placebo group: 4.5%), and discharge from the hospital (TSP group: 134.8 min, placebo group: 150.0 min) were not different from each other group. There were no severe complications associated with TSP. Total incidence of side effects was higher in the TSP group than the placebo group (TSP group: 59%, placebo group: 14%) (P < 0.05) but dry mouth (PST group: 41%, placebo group: 0%) of the PST group was the most frequent and only significant individual complication compared to the placebo group. CONCLUSIONS TSP did not reduce PONV and induced frequent mild side effects especially dry mouth in conization patients. |
Key Words:
Outpatient; postoperative nausea and vomiting; transdermal scopolamine |
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