INTRAVENOUS ONDANSETRON FOR POSTSURGICAL OPIOID-INDUCED NAUSEA AND VOMITING

The use of opioids for postoperative analgesia may be limited by side effects such as nausea and vomiting. Because ondansetron, a selective serotonin type 3 (5-hydroxytryptamine [5-HT3]) antagonist, is effectiv e for chemotherapy and general anesthesia-induced nausea and vomiting, we hypothesized that it may also be effective for opioid-induced naus ea and vomiting. ASA physical status I-III patients undergoing regiona l anesthesia were eligible for the study. Those who requested an antie metic after postsurgical opioid administration were randomized to rece ive a single dose of ondansetron (0.1 mg, 4 mg, or 16 mg intravenously [IV]) or placebo in a double-blind fashion. Emetic episodes, nausea a nd pain ratings, and adverse events were recorded for 24 h after study drug administration. Patient satisfaction scores were obtained 24 h a fter study drug infusion. A significantly (P < 0.05) larger proportion of patients treated with ondansetron 4 mg and 16 mg experienced no em etic episodes, received no rescue antiemetic, and completed the study compared with placebo. Nausea scores and patient satisfaction scores i n the ondansetron 16-mg group were significantly (P < 0.05) more favor able than in the placebo group. Postsurgical pain scores did not diffe r among groups. The incidence of adverse events was similarly low acro ss groups. The results of this study support our hypothesis that IV on dansetron is effective for postsurgical opioid-induced nausea and vomi ting.