| The Effect of Ondansetron and Metoclopramide on the Prevention of Postoperative Nausea and Vomiting After Using Epidural Morphine-Butorphanol Mixture. |
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Mi Ae Han, Ki Hyuk Hong |
1Department of Anesthesiology and Pain Medicine, Seoul Paik Hospital, Korea. hama159@hanmail.net
2Department of Anesthesiology Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea. |
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| Abstract |
BACKGROUND
Neuroaxial morphine may produce nausea and vomiting due to cephalad migration. Though it improves post- operative pain, it may have serious complication delaying recovery. The aim of this study was to investigate the efficacy of prophylactic antiemetics such as conventional metoclopramide or more expensive ondansetron.
METHODS
Eighty-seven patients who underwent orthopedic knee arthroscopic surgery under epidural anesthesia were randomly assigned to three groups, which are (a) normal saline intravenous injection control group (Group C), (b) metoclopramide intravenous injection and intranasal spray study group (Group M), (c) ondansetron inravenous injection group (Group O). Before the end of surgery, all patients were given 3 mg of morphine and 2 mg of butorphanol mixture via epidural catheter for postoperative pain control. The anesthesia were all standardized. Post-operative nausea and vomiting were observed and used as outcome variables and postoperative pain, itching, somnolence, dizziness, urinary retention were also observed.
RESULTS
The incidence of postoperative nausea was significantly lower in Group M (P = 0.0296) and Group O (P = 0.005) compared with Group C. The incidence of postoperative vomiting was significantly lower in Group O (P = 0.01) compared with Group C. But statistically no difference was noted in vomiting between Group C and Group M (P = 0.0579).
CONCLUSIONS
The results suggest that ondansetron and metoclopramide are effective in reducing the incidence of post-operative nausea. But ondansetron is more effective in reducing the incidence of post-operative morphine induced vomiting. |
| Key Words:
epidural morphine; post-operative nausea and vomiting |
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