PREVENTION OF NAUSEA AND VOMITING AFTER DAY-CASE GYNECOLOGICAL LAPAROSCOPY - A COMPARISON OF ONDANSETRON, DROPERIDOL, METOCLOPRAMIDE AND PLACEBO

We have compared the efficacy of ondansetron, metoclopramide, droperid ol and placebo in the prevention of postoperative nausea and vomiting in 118 day stay patients undergoing laparoscopic gynaecological proced ures. All received a standardised general anaesthetic of fentanyl, pro pofol, nitrous oxide in oxygen and isoflurane. Three to five min befor e induction of anaesthesia, patients were allocated to receive ondanse tron 4 mg, metoclopramide 10 mg, droperidol 1 mg or placebo in a rando mised, double-blind manner. Visual analogue scores for nausea, the inc idence of emetic episodes, and analgesic and antiemetic consumption we re recorded for 48 h postoperatively. The scores for nausea were signi ficantly lower in the ondansetron group (p < 0.01) compared with the o ther three groups at 1, 2 and 4 h after operation; thereafter there wa s no difference. The incidence of emesis was lower (p = 0.063) and tim e to first oral fluids was shorter (p < 0.05) in the ondansetron group . Oral analgesic requirements were significantly greater in the ondans etron group over the 48 h study period. Two patients, one each in the placebo and metoclopramide groups, had to remain in hospital overnight because of persistent emetic symptoms.