The effect of preoperative ondansetron on the incidence of postoperative nausea and vomiting in patients undergoing outpatient dentoalveolar surgery and general anesthesia
C. Wagley et al., The effect of preoperative ondansetron on the incidence of postoperative nausea and vomiting in patients undergoing outpatient dentoalveolar surgery and general anesthesia, J ORAL MAX, 57(10), 1999, pp. 1195-1200
Purpose: The purpose of this investigation was to evaluate the efficacy of
ondansetron in controlling postoperative nausea and vomiting (PONV) when us
ed prophylactically in patients undergoing routine dentoalveolar surgery pe
rformed under general anesthesia.
Patient and Methods: This was a prospective, double-blind, randomized, plac
ebo-controlled evaluation. Fifty adult ASA I or II patients, requiring rout
ine dentoalveolar surgery performed under general anesthesia, without a pri
or history of PONV, were randomly assigned to the experimental or control g
roups. Ondansetron (2.0 mL = 4.0 mg) or normal saline (2.0 mL) were adminis
tered intravenously before surgery. Age, gender, type of surgery, duration
of surgery, anesthetic dosages, and PONV were evaluated. PONV was evaluated
at time 0 (end of anesthesia) and at 30 and 60 minutes postoperatively. Na
usea was evaluated using a visual analog scale (1, not nauseous; 5, about t
o vomit). Vomiting was assessed as ayes or no response. At 20 to 28 hours p
ostoperatively, PONV was evaluated via a telephone call as ayes or no respo
nse, along with the number of episodes of nausea, vomiting, or both. Means
and standard deviations were calculated for age, surgery, and anesthetics,
and differences were assessed using an independent samples t-test. Differen
ces for gender between the control and experimental groups were tested by a
nonparametric chi-squared test. Differences between groups for nausea and
vomiting were tested with a continuity correction chi-squared test. Differe
nces were considered significant for a P <.05.
Results: No significant differences (P<.05) were found between the PONV gro
ups for gender, duration of procedure, or anesthetic dosages. Statistically
significant differences were noted in age and the type of surgical procedu
res performed. No statistically significant differences (P <.05) were noted
between groups for nausea or vomiting.
Conclusion: Based on the results of this study, PONV occurred in approximat
ely 20% of patients (20% for nausea, 8% for vomiting). With the types of an
esthetic agents and techniques used in this investigation, there were no si
gnificant differences between ondansetron and placebo for prophylaxis again
st PONV.