DROPERIDOL-ONDANSETRON COMBINATION VERSUS DROPERIDOL ALONE FOR POSTOPERATIVE CONTROL OF EMESIS AFTER TOTAL ABDOMINAL HYSTERECTOMY

Study Objectives: To investigate the hypothesis that the combination o f ondansetron and droperidol would be more effective than droperidol a lone in reducing nausea and vomiting. Design: Randomized, double-blind study. Setting: Magee-Womens Hospital, Pittsburgh, Pennsylvania. Pati ents: 160 healthy, ASA physical status I and II, female patients sched uled for total abdominal hysterectomy. Interventions: After induction of anesthesia with propofol, Group 1 received intravenous (IV) droperi dol 1.25 mg plus IV ondansetron 4 mg. Group 2 received IV droperidol p lus IV saline. Measurements and Main Results: The complete response (n o emesis, no rescue) for Group 1 was 36 of 80 patients (45%) versus 30 of 80 patients (38%) in Group 2 (p = 0.21). In Group 1, 42 of 80 pati ents (53%) required rescue antiemetic as compared with 44 of 80 patien ts (55%) in Group 2 (p = 0.43). There were 72 total rescues in Group 1 versus 73 in Group 2, (p = 0.24). Mean time until first rescue was 57 8 +/- 429 minutes in Group 1 and 418 +/- 354 minutes in Group 2, (p = 0.03). In Group 1, 81% (34/42) were rescued for nausea only versus 90% (39/44) of Group 2, (p = 0.16). In Group 1, 21% of patients (17/80) h ad at least one emetic episode versus 34% (27/80) of Group 2 patients (p = 0.05). There were 31 emetic episodes in Group 1 versus 72 episode s in Group 2, (p = 0.02). Mean time to the first emetic episode was 69 9 +/- 403 minutes in Group 1 and 616 +/- 376 minutes in Group 2, (p = 0.23). Conclusion: For patients undergoing total abdominal hysterectom ies, the addition of ondansetron to droperidol increases the time unti l first rescue and reduces the number of emetic episodes, as well as t he percentage of patients, having at least one emetic episode. (C) 199 8 by Elsevier Science Inc.