Comparison of ondansetron and cyclizine for prevention of nausea and vomiting after day-case gynaecological laparoscopy

We have compared ondansetron 4 mg i.v. and cyclizine 50 mg i.v., in a doubl e-blind, randomized, placebo-controlled study for the prevention of postope rative nausea and vomiting (PONV) for 24 h after day-case gynaecological la paroscopy. Compared with placebo (n = 58), ondansetron (n = 60) and cyclizi ne (n = 57) reduced significantly the incidence of moderate or severe nause a (30% and 23% vs 52%; P = 0.02 and P = 0.001, respectively) and requiremen t for escape antiemetic (28% and 16% vs 47%; P = 0.04 and P < 0.001, respec tively) before discharge from hospital. There were no significant differenc es in PONV after discharge. Significantly more patients suffered no PONV be fore and after discharge after ondansetron and cyclizine compared with plac ebo (31% and 33% vs 12%; P = 0.02 and P < 0.01, respectively). For diagnost ic laparoscopy (n = 74), fewer patients received escape antiemetic after cy clizine than after ondansetron (4% vs 37%; P < 0.01); for laparoscopic ster ilization (n = 101), both antiemetics were equally effective. Ondansetron a nd cyclizine both reduced severe and moderate nausea and the need for antie metic therapy after day-case gynaecological laparoscopy.