Pkm. Ku et al., Efficacy of ondansetron for prevention of postoperative-nausea and vomiting after outpatient ear surgery under local anesthesia, AM J OTOL, 21(1), 2000, pp. 24-27
Objective: To assess the efficacy and safety of intravenous ondansetron (4
mg) for the prevention of nausea and vomiting after middle ear surgery unde
r local anesthesia.
Setting: The study was conducted by Division of Otorhinolaryngology in Prin
ce of Wales Hospital, which is a tertiary referral center and teaching hosp
ital for The Chinese University of Hong Kong.
Study Design: A double-blind randomized controlled trial. Patients: Fifty-e
ight Chinese patients undergoing tympanoplasty under local anesthesia from
July 1995 to June 1997 were recruited. The mean age of patients was 42.8 ye
ars (range 18-71 years).
Intervention: Patients were randomly allocated to receive a single dose of
intravenous ondansetron (4 mg) (n = 29) or placebo (n = 29) immediately bef
ore surgery.
Main Outcome Measures: Patients were assessed far severity and frequency of
postoperative nausea and vomiting at the Ist, 2nd, 4th, 8th, and 24th hour
s after:middle ear surgery.
Results: Female patients showed a higher prevalence of postoperative nausea
and vomiting. Twenty-eight percent of the patients experienced postoperati
ve nausea, of whom 14% also experienced vomiting. Although the ondansetron
group demonstrated a lower prevalence of postoperative nausea and vomiting
(PONV) (24% nausea and 10% vomiting) than the placebo group (31% nausea and
17% vomiting), significant reduction in postoperative vomiting only occurr
ed in the first postoperative hour (p = 0.038). No complications or adverse
side effects were found to be associated with the use of ondansetron.
Conclusions: Single-dose ondansetron (4 mg) given intravenously preoperativ
ely significantly reduces postoperative vomiting in patients after tympanop
lasty under local anesthesia and causes no adverse effects.