INTRAVENOUS DOLASETRON FOR THE PREVENTION OF POSTOPERATIVE NAUSEA ANDVOMITING AFTER OUTPATIENT LAPAROSCOPIC GYNECOLOGIC SURGERY

The newer 5-hydroxytryptamine type 3 (5-HT3) antagonists are sometimes considered for routine prophylaxis of postoperative nausea and vomiti ng (PONV) in high-risk patients. This multicenter, randomized, double- blind, placebo-controlled study compared the efficacy and safety of th ree single intravenous (IV) doses of dolasetron mesylate salt (12.5, 2 5, or 50 mg) for the prevention of PONV in 635 females undergoing outp atient laparoscopic gynecologic surgery. Antiemetic efficacy was evalu ated over a 24-h postoperative period by recording the number and timi ng of emetic episodes; effects on nausea were evaluated by a visual an alog scale (VAS). The proportion of complete responders (no emetic epi sodes and no escape medication in 24 h) was significantly higher with each dolasetron mesylate dose (> 50% for each dose; P less than or equ al to 0.0003) than with placebo (30.6%). Fewer patients given dolasetr on required or requested escape antiemetic medication compared with pl acebo (P < 0.0003). Dolasetron-treated patients had significantly (P < 0.0357) lower median postdose maximum nausea VAS scores compared with placebo-treated patients. Patient satisfaction with dolasetron was hi gh and, overall, was significantly (P = 0.0131) greater than that with placebo. Dolasetron was an effective and well tolerated preventive tr eatment for PONV resulting from laparoscopic gynecologic surgery.