The effect of timing of dolasetron administration on its efficacy as a prophylactic antiemetic in the ambulatory setting

Dolasetron (12.5 mg IV) is effective in both preventing and treating postop erative nausea and vomiting (PONV) after ambulatory surgery. However, the o ptimal timing of dolasetron administration and its effect on the patient's quality of life after discharge have not been established. One-hundred-five healthy, consenting women undergoing gynecologic laparoscopic procedures w ith a standardized general anesthetic technique were enrolled in this rando mized, double-blinded study. Group I received dolasetron 12.5 mg IV 10-15 m in before the induction of anesthesia; Group 2 received dolasetron 12.5 mg IV at the end of the laparoscopy (79 +/- 48 min later than Group 1); and Gr oup 3 received dolasetron 12.5 mg IV at the end of anesthesia (93 +/- 52 mi n later than Group 1). The incidence of PONV, complete responses (defined a s no emetic episodes and no rescue medication within the 24-h period after anesthesia), recovery profiles, and patient satisfaction were recorded. In the postanesthesia care unit and during the 24-h follow-up period, the inci dence of nausea and vomiting, as well as the need for rescue antiemetics, d id not differ significantly among the three groups. The percentages of pati ents with complete responses to the study drug within the first postoperati ve 24 h were also similar in all three groups (55%, 59%, and 52% for Groups 1, 2, and 3, respectively). The early and intermediate recovery profiles, including resumption of a normal diet and patient satisfaction with the con trol of PONV, were not different among the three study croups. Dolasetron 1 2.5 mg IV administered before the induction of anesthesia is as effective a s dolasetron given at the end of laparoscopy or at the end of anesthesia in preventing PONV after outpatient laparoscopy.