PROPHYLACTIC ANTIEMETICS FOR LAPAROSCOPIC CHOLECYSTECTOMY - A COMPARISON OF PERPHENAZINE, DROPERIDOL PLUS ONDANSETRON, AND DROPERIDOL PLUS METOCLOPRAMIDE

Study Objective: To compare the prophylactic administration of ondanse tron plus droperidol, droperidol plus metoclopramide, and perphenazine to determine effects on postoperative nausea, vomiting and sedation a fter laparoscopic cholecystectomy. Design: Prospective, randomized, do uble-blind study. Setting: University medical center. Patients: 212 AS A physical status I and II adults presenting for laparoscopic cholecys tectomy. Interventions: Patients were randomly assigned to receive one of three prophylactic antiemetic drug combinations: ondansetron 4 mg plus droperidol 0.625 mg (Group OD), droperidol 0.625 mg plus metoclop ramide 10 mg (Group DM), or perphenazine 5 mg (Group P). Study drugs w ere administered intravenously after induction of general anesthesia. Measurements and Main Results: The groups were similar with respect to gender, age, weight, duration of surgery, numbers of patients receivi ng intraoperative atropine or ephedrine, number admitted overnight, an d time to discharge home. Patients in Group P used lower total doses o f opioids than did patients in Group OD. There were no significant dif ferences in postoperative nausea, pain, or sedation scores, in numbers of patients requiring antiemetics (Group OD, 13 of 66; Group DM, 15 o f 66; Group P, 14 of 68), or in numbers of patients vomiting either in hospital or during the first postoperative day. Conclusions: These th ree drug regimens are equivalent for antiemetic prophylaxis before lap aroscopic cholecystectomy. (C) 1998 by Elsevier Science Inc.