Combination of transcutaneous electrical nerve stimulation and ondansetronin preventing cisplatin-induced emesis

Objective: To find out whether the combination of transcutaneous electrical nerve stimulation (TENS) and ondansetron had an increased antiemetic effec t. Materials and Methods: Fourteen testis and 11 bladder cancer patients we re scheduled for 4 cycles of bleomycin-etoposide-cisplatin (BEP) or methotr exate-vinblastine-etoposide-cisplatin (MVEC) combination chemotherapy, resp ectively. At each cycle the whole cisplatin dose was given in 1 day that is 100 mg/m(2)/day in the BEP and 70 mg/m(2)/day in the MVEC protocols. Ondan setron was given at a dose of 12 mg/day and TENS was applied by commerciall y available 'Relief Band'(Maven Labs, Inc., Citrus Heights, Calif., USA). T he first 3 cycles of each case were blindly randomized to one of the follow ing regimens; TENS vs. ondansetron vs. a combination of both. The regimens were applied during the administration of cisplatin and the patients were a sked to report their nausea according to a scale between 0 to 10. Also for each regimen the number of emetic attacks experienced during the administra tion of cisplatin was recorded by the same observer. Then the scores of eac h regimen were compared. Results: The mean nausea scores for regimens TENS, ondansetron and TENS + ondansetron were found to be 5.12 +/- 2.54, 3.0 +/- 1.71 and 0.8 +/- 0.96, respectively. Ondansetron was better than TENS in p reventing nausea (p = 0.000). However the combination of TENS and ondansetr on resulted in a significant decrease in nausea scores when compared to TEN S alone (p = 0.000) or ondansetron alone (p = 0.000). The mean number of em etic attacks for the TENS, ondansetron and TENS + ondansetron regimens were 3.16 +/- 1.84, 1.64 +/- 1.44 and 0.56 +/- 0.82, respectively. A statistica lly significant difference was present between the number of emetic attacks observed with the TENS + ondansetron combination and TENS alone (p = 0.000 ) or ondansetron alone (p = 0.001). Ondansetron was again better than TENS in preventing emetic attacks (p = 0.001). Conclusion:The use of TENS as an adjunct to ondansetron therapy has provided significant benefit in preventi ng nausea and emetic attacks caused by cisplatin. Copyright (C) 2001 S. Kar ger AG, Basel.