Postoperative nausea and vomiting after breast surgery: efficacy of prophylactic ondansetron and droperidol in a randomized placebo-controlled study

Postoperative nausea and vomiting (PONV) is a common adverse phenomenon fol lowing breast surgery. The efficacy of ondansetron and droperidol in preven ting post-operative nausea and vomiting in women undergoing breast surgery was compared in this randomized, double-blind, placebo-controlled study. Al together 207 women were randomly assigned to receive either a single intrav enous dose of droperidol (1.25 mg) (n = 69), ondansetron (8 mg) (n = 67) or saline (n = 71) immediately after induction of general anaesthesia with th iopental, fentanyl, atracurium, nitrous oxide in oxygen and isoflurane. Com plaints of nausea, vomiting and requests for rescue antiemetics were record ed during a 24-h period postoperatively. During the initial 2 h in the post anaesthesia care unit, the incidence of postoperative nausea and vomiting w as 15%, 6% and 12% in the placebo, droperidol and ondansetron groups, respe ctively (NS). The incidence of post-operative nausea and vomiting during th e first 24 h was 61%, 48% and 45% in the placebo, droperidol and ondansetro n treatment groups, respectively (NS). Postoperative analgesic requirements and the length of stay in the post-anaesthesia care unit were equal in all three treatment groups. It is concluded that the intravenous pretreatment with single doses of ondansetron or droperidol did not substantially preven t postoperative nausea and vomiting after breast surgery.