COMPARISON OF ONDANSETRON AND DROPERIDOL IN THE PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING AFTER LAPAROSCOPIC SURGERY IN WOMEN - A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL

Background: Women undergoing laparoscopic surgery are susceptible to p ostoperative nausea and vomiting (PONV). Ondansetron and droperidol ar e useful antiemetics. This study was designed to ascertain primarily t he relative difference in efficacy of ondansetron and droperidol and s econdarily between these drugs and placebo in the prevention of PONV a fter laparoscopic surgery. Methods: The prophylactic antiemetic effica cy of ondansetron and droperidol was compared in a prospective, random ised, double-blind, placebo-controlled trial of 439 female inpatients scheduled for laparoscopic surgery. During induction of standardised g eneral anaesthesia the patients received intravenously either ondanset ron 8 mg (n=195), droperidol 1.25 mg (n=193) or placebo (n=51). The oc currence of nausea, vomiting, side-effects and the need for rescue ant iemetic medication were recorded for 24 h postoperatively. Results: Th e proportion of patients with nausea was 48%, 50% and 67% in the ondan setron, droperidol and placebo groups, respectively; with a significan t difference when both ondansetron (P=0.02) and droperidol (P=0.04) we re compared with placebo. Vomiting occurred in 18%, 26% and 37% of the patients in the three groups, respectively (P=0.05 between ondansetro n and droperidol, P=0.004 between ondansetron and placebo, P=0.16 betw een droperidol and placebo). The proportion of patients given rescue m edication was 34%, 28% and 49%, respectively (P=0.23 for ondansetron a nd droperidol, P=0.07 for ondansetron and placebo, P=0.007 for droperi dol and placebo). During early recovery the patients treated with onda nsetron were significantly more alert than after droperidol. Serious s ide-effects were not observed. Headache was significantly more common after ondansetron than after droperidol treatment. Conclusions: The ef ficacy of prophylactic ondansetron and droperidol in reducing postoper ative nausea associated with laparoscopic surgery in female inpatients was similar, but ondansetron appeared to be slightly more efficient t han droperidol in preventing vomiting. Ondansetron and droperidol were both significantly better than placebo in the prophylaxis of PONV.