Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942006000100002
Brazilian Journal of Anesthesiology
Scientific Article

Eficácia do ondansetron, metoclopramida, droperidol e dexametasona na prevenção de náusea e vômito após laparoscopia ginecológica em regime ambulatorial. Estudo comparativo

Efficacy of ondansetron, metoclopramide, droperidol and dexametasone in preventing post-gynecological videolaparoscopy nausea and vomiting in outpatient setting. Comparative study

Múcio Paranhos de Abreu; João Lopes Vieira; Iara Ferreira da Silva; Luiz Eduardo Paula G Miziara; Renata Fófano

http://dx.doi.org/10.1590/S0034-70942006000100002 Braz J Anesthesiol, vol.56, n1, p.8-15, 2006
PDF Português
PDF English
Downloads: 1
Views: 1638

Resumo

JUSTIFICATIVA E OBJETIVOS: Embora o ondansetron seja apontado como uma das drogas mais eficientes no controle das náuseas e vômitos pós-operatório (NVPO), seu alto custo o torna inviável para uso rotineiro. Este estudo teve como finalidade verificar entre o droperidol, a metoclopramida e a dexametasona qual se aproxima mais da eficácia do ondansetron na prevenção de NVPO em laparoscopias ginecológicas. MÉTODO: Participaram do estudo 100 pacientes submetidas à laparoscopia ginecológica sob anestesia geral venosa e inalatória, divididas aleatoriamente em cinco grupos de acordo com a medicação antiemética recebida. O grupo GO (n = 20) recebeu ondansetron (4 mg); o grupo GM (n = 20): metoclopramida (10 mg); grupo GD (n = 20): droperidol (1,25 mg), o grupo GX (n = 20): dexametasona (8 mg) e o grupo GC - grupo controle (n = 20) não recebeu medicação antiemética. Foram verificadas as incidências de náusea e/ou vômito no pós-operatório, os parâmetros hemodinâmicos, o tempo na sala de recuperação pós-anestésica (SRPA) e o tempo da anestesia. RESULTADOS: Não houve diferença estatística entre os grupos quanto aos dados antropométricos, hemodinâmicos, tempo de recuperação e tempo de anestesia. Houve diferença estatística entre os grupos quanto à incidência de náusea (GO < GD < GX < GM < GC) e de vômitos (GO < GD < GX < GM < GC). CONCLUSÕES: Neste estudo, o ondansetron foi o agente mais eficaz na profilaxia de náusea e vômito e o droperidol foi a droga que mais se aproximou da eficácia do ondansetron na prevenção de NVPO.

Palavras-chave

ANTIEMÉTICOS, ANTIEMÉTICOS, ANTIEMÉTICOS, ANTIEMÉTICOS, CIRURGIA, Ginecológica, COMPLICAÇÕES, COMPLICAÇÕES

Abstract

BACKGROUND AND OBJECTIVES: Although being considered one of the most effective drugs to control postoperative nausea and vomiting (PONV), ondansetron is unfeasible for routine use due to its high cost. This study aimed at comparing the efficacy of droperidol, metoclopramide, and dexametasone as compared to ondansetron in preventing PONV after gynecological laparoscopies. METHODS: Participated in the study 100 patients submitted to gynecological laparoscopies under general intravenous and inhalational anesthesia, who were randomly distributed in five groups according to the antiemetic medication. Group GO (n = 20) received ondansetron (4 mg); Group GM (n = 20) received metoclopramide (10 mg); Group GD (n = 20) received droperidol (1.25 mg); Group GX (n = 20) received dexametasone (8 mg); and Group GC - control group (n = 20) was not medicated. The following events were recorded: incidence of postoperative nausea and/or vomiting, hemodynamic parameters, PACU stay and anesthetic length. RESULTS: There were no statistically significant differences among groups in demographics, hemodynamic parameters, recovery and anesthetic length. There were statistical differences among groups in the incidence of nausea (GO < GD < GX < GM < GC) and vomiting (GO < GD < GX < GM < GC). CONCLUSIONS: Ondansetron was the most effective agent in preventing nausea and vomiting, and droperidol was the closest drug to ondansetron in preventing PONV.

Keywords

ANTIEMETICS, ANTIEMETICS, ANTIEMETICS, ANTIEMETICS, COMPLICATIONS, COMPLICATIONS, SURGERY: Gynecological

References

Kenny GN. Risk factors for postoperative nausea and vomiting. Anaesthesia. 1994;49(^sSuppl).

Schmidt A, Bagatini A. Náusea e vômito pós-operatório: fisiopatologia, profilaxia e tratamento. Rev Bras Anestesiol. 1997;47:326-334.

Heyland K, Dangel P, Gerber AC. Postoperative nausea and vomiting (PONV) in chuldren. Eur J Pediatr Surg. 1997;7:230-233.

Yuen HK, Chiu JW. Multimodal antiemetic therapy and emetic risck profiling. Ann Acad Med Singapore. 2005;34:196-205.

Lerman J. Surgical and patient factor involved in postoperative nausea and vomiting. Br J Anaesth. 1992;69(^s7):24S-32S.

Abreu MP. Náuseas e Vômitos: Antieméticos. Anestesia Ambulatorial. 2001;23:339-357.

Ganem EM, Fabris P, Moro MZ. Eficácia do ondansetron e da alizaprida na prevenção de náusea e vômito em laparoscopia ginecológica. Rev Bras Anestesiol. 2001;51:401-406.

Koivuranta M, Ala-Kokko TI, Jokela R. Comparison of ondansetron and tropisetron combined with droperidol for the prevention of emesis in women with a history of post-operative náusea and vomiting. Eur J Anaesthesiol. 1999;16:390-395.

Domino KB, Anderson EA, Polissar NL. Comparative efficacy and safety of ondansetron, droperidol, and metoclopramide for preventing postoperative nausea and vomiting: a meta-analysis. Anesth Analg. 1999;88:1370-1379.

Mckenzie R, Kovac A, O’Connor T. Comparison of ondansetron versus placebo to prevent postoperative nausea and vomiting in women undergoing ambulatory gynecologic surgery. Anesthesiology. 1993;78:21-28.

Porto AM. Recuperação da Anestesia. Anestesia Ambulatorial. 2001:311-322.

Porto AM. Critérios de Alta. Anestesia Ambulatorial. 2001:323-336.

Malins AF, Field JM, Nesling PM. Nausea and vomiting after gynaecological laparoscopy: comparison of premedication with oral ondansetron, metoclopramide and placebo. Br J Anaesth. 1994;72:231-233.

Suen TK, Gin TA, Chen PP. Ondansetron 4 mg for the prevention of nausea and vomiting after minor laparoscopic gynaecological surgery. Anaesth Intensive Care. 1994;22:142-146.

Raphael JH, Norton AC. Antiemetic efficacy of prophylactic ondansetron in laparoscopic surgery: randomized, double-blind comparison with metoclopramide. Br J Anaesth. 1993;71:845-848.

Fujii Y, Saitoh Y, Tanaka H. Granisetron/dexametasone combination for reducing nausea and vomiting during and after spinal anesthesia for cesarean section. Anesth Analg. 1999;88:1346-1350.

Fujii , Saitoh , Tanaka H. Prophylactic therapy with combined granisetron and dexametasone for the prevention of post-operative vomiting in children. Eur J Anaesthesiol. 1999;16:376-379.

Mckenzie R, Uy NT, Riley TJ. Droperidol/ondansetron combinations controls nausea and vomiting after tubal banding. Anesth Analg. 1996;83:1218-1222.

5dd4377a0e88250152c63496 rba Articles
Links & Downloads
2352-2291 (Electronic) 0104-0014 (Printed)
Braz J Anesthesiol ©2024 All rights reserved.

Braz J Anesthesiol

Share this page
Page Sections