NEOSTIGMINE WITH GLYCOPYRROLATE DOES NOT INCREASE THE INCIDENCE OR SEVERITY OF POSTOPERATIVE NAUSEA AND VOMITING IN OUTPATIENTS UNDERGOING GYNECOLOGICAL LAPAROSCOPY

We studied 100 healthy women undergoing outpatient gynaecological lapa roscopy in a randomized, double-blind and placebo-controlled study to evaluate the effect of neostigmine on postoperative nausea and vomitin g (PONV). After induction of anaesthesia with propofol, anaesthesia wa s maintained with sevoflurane and 66% nitrous oxide in oxygen. Mivacur ium was used for neuromuscular block. At the end of anaesthesia, neost igmine 2.0 mg and glycopyrrolate 0.4 mg, or saline, was given i.v. The incidence of PONV was evaluated in the postanaesthesia care unit, on the ward and at home. The severity of nausea and vomiting, worst pain, antiemetic and analgesic use, times to urinary voiding and home readi ness were recorded. During the first 24 h after operation, 44% of pati ents in the neostigmine group and 43% in the saline group did not have PONV. We conclude that neostigmine with glycopyrrolate did not increa se the occurrence of PONV in this patient group.