枢复宁TM预防小儿腭裂修补术后恶心,呕吐的临床研究

探讨了小儿腭裂手术后静脉注射枢复宁ＴＭ对术后恶心呕吐的影响。４５例ＡＳＡⅠ～Ⅱ级，年龄３～１０岁，择期行腭裂修补术的患儿随机分成三组：第Ⅰ组不用枢复宁ＴＭ，第Ⅱ组于麻醉后手术前静脉注射枢复宁ＴＭ０．１ｍｇ／ｋｇ，第皿组术毕静脉注射枢复宁ＴＭ０．１ｍｇ／ｋｇ。麻醉前３０分钟肌注阿托品０．０１ｍｇ／ｋｇ和苯巴比妥钠３ｍｇ／ｋｇ。用氯胺酮５ｍｇ／ｋｇ肌肉注射或１ｍｇ／ｋｇ静脉注射行麻醉诱导后，用羟丁酸钠５０ｍｇ／ｋｇ和０．１％氯胺酮维持麻醉。术毕患儿均在恢复室观察直至完全清醒方送近病房。醒后４小时开始进流质。结果第Ⅰ、Ⅱ、Ⅲ组患儿术后恶心、呕吐发生率分别为１１／１５（７３．３３％）、７／１５（４６．６７％）、２／１５（１３．３３％）（Ｐ＜０．０１）。本研究表明：术毕静脉注射枢复宁ＴＭ０．１ｍｇ／ｋｇ能有效预防小儿腭裂术后恶心、呕吐，不提倡术前预防性应用枢复宁ＴＭ。     

应用枢复宁预防术后恶心呕吐

我们观察了麻醉诱导前静脉注射单次剂量枢复宁（４ｍｇ）预防静吸复合麻醉下腹部手术后恶心呕吐的效应及安全性。结果表明：本组６５例无一例发生术后呕吐，仅９例有术后恶心。与文献报道结果相比，枢复宁（４ｍｇ）可明显减少手术后２４小时内恶心呕吐的发生率及其程度，对肝、肾功能、血液学指标以及呼吸、血压、心率等无影响，枢复宁用于围术期安全有效，是一种较为理想的抗呕吐药物。     

不同配伍芬太尼术后硬膜外病人自控镇痛效应的比较

目的：采用硬膜外病人自控镇痛（ＰＣＥＡ）技术，对不同配伍芬太尼术后镇痛效应进行了研究。方法：１００例（ＡＳＡⅠ～Ⅱ级）手术病例随机分成三组，Ｆ组（ｎ＝２０）：用０．０００４％芬太尼＋０．１５％丁哌卡因；ＢＦ组（ｎ＝４０）：用Ｆ组药液＋０．０００９％丁丙诺啡；ＭＦ组（ｎ＝４０）：用Ｆ组药液＋０．００５％吗啡；采用双盲法对比观察。结果：术后２４小时三组病人ＶＡＳ评级Ｆ组最高（Ｐ＜０．０５），ＰＣＥＡ总按数／实进数（Ｄ／Ｄ）比值在０～２范围内的病例数，ＭＦ组≈ＢＦ组＞Ｆ组（Ｐ＜０．０５），提示ＭＦ、ＢＦ组镇痛效果较好。三组病人ＰＣＥＡ期间呼吸、循环无明显变化，恶心、呕吐等并发症较低（２．５％～５．０％），后两组有１０％～１５％病人嗜睡。结论：选择芬太尼和丁哌卡因行ＰＣＥＡ时，复合小剂量吗啡（０．００５％）或丁丙诺啡（０．０００９％）其镇痛效果更好。     

术前肝动脉化疗栓塞对肝细胞癌切除术疗效影响的探讨

为了探讨术前肝动脉栓塞（ＴＡＥ）能否改善肝癌切除术预后，作者分析了肿瘤直径３ｃｍ以上，无门静脉癌栓的７７例患者，术前进否行肝动脉化疗栓塞对肝癌切除术后疗效影响，７７例患者按术前是否接受ＴＡＥ分为栓塞组（Ａ组，ｎ＝２６）和非栓塞组（Ｂ组，ｎ＝５１），每组按肿瘤直径再分Ａ１，Ｂ１（３～８ｃｍ），Ａ２，Ｂ２（〉８．０ｃｍ）两个亚组，结果术后１，２，３年无瘤存活率各组分别为Ａ１组（ｎ＝１４）的５０．０％，     

脑氧饱和度监测的临床意义及评价

通过体外循环心内直视术（ｎ＝２０）及颅脑手术（ｎ＝２０）脑氧饱和度的监测发现，麻醉诱导时脑氧饱和度增加（Ｐ＜０．０５），体外循环心内直视手术患者复温过程中，脑氧饱和度明显下降（由７０．０％±４．５％降至６０．３％±９．２％，Ｐ＜０．０１），转流停止后上升。脑外患者拔管后脑氧饱和度下降（Ｐ＜０．０５）。无论在降温还是复温过程中，脑氧饱和度与转流量之间呈线性相关（ｒ＝０．８６５～０．９４５，Ｐ＜０．０５），ＰＥＴ－ＣＯ２明显影响脑氧饱和度。ＨＲ（５０～１４０次／分）及转流中ＭＡＰ（３·４６～１４·６ｋＰａ），脑氧饱和度无明显变化。结论：（１）监测脑氧饱和度可反映脑氧供需平衡；（２）凡能影响脑氧供（如动脉血氧合、转流量及Ｐ。ＴＣＯ２等）及脑氧需（如体温等）的因素均可引起脑氧饱和度变化；（３）脑氧饱和度严重进行性下降而且不能恢复提示预后不良。     

术后镇痛对老年人上腹部手术后肺功能的影响

３２例 ＡＳＡ Ⅱ～Ⅲ级择期行上腹部手术（ＵＡＳ）的老年患者随机分成两组：对照组（ｎ＝１６）和术后每６小时用 ０． １２５％丁听卡因十芬太尼０．０２５ｍｇ １０ｍｌ行硬膜外镇痛（ＰＥＡ）组（ｎ＝１６），分析两组患者术前，拔管时，术后４、８和２４小时的呼吸频率（ＲＲ）、潮气量（ＶＴ）、分钟通气量（ＭＶ）和动脉血ｐＨＰａＯ２、ＰａＣＯ２、ＮＣＯ０－３、ＢＥ－Ｂ、Ｏ２Ｓａｔ。结果表明：虽术后持续鼻导管吸氧，对照组仍出现严重的呼吸抑制和酸碱平衡紊乱，尤以术后８小时内，特别是４小时内最严重；而镇痛组则程度轻微且无明显缺氧、二氧化碳蓄积和酸碱平衡失调。可见用０．１２５％丁哌卡因十芬太尼０．０２５ｍｇ １０ｍｌ行ＰＥＡ能改善老年患者的术后肺功能。但在ＰＥＡ期间仍应继续进行呼吸监测，并常规给予吸氧至少８小时。//     

昂丹司琼预防腹腔镜胆囊切除术后恶心呕吐的疗效观察

目的探讨腹腔镜胆囊切除手术后静脉注射昂丹司琼对术后恶心呕吐的预防疗效。方法90例ASAⅠ-Ⅱ级，择期腹腔镜胆囊切除术患者随机分成3组。第1组对照组，术后给予生理盐水5ml。第Ⅱ组氟哌利多组，术后静注氟哌利多1．25mg。第Ⅲ组术后静注枢复宁4mg。观察术后24h患者的恶心呕吐情况。结果第Ⅰ、Ⅱ、Ⅲ组患者恶心呕吐发生率分别为60、0％、30．0％、26．7％。第Ⅱ组与第Ⅰ组之间差异有显著性（P〈0．05），第Ⅲ组与第Ⅰ组之间差异有非常显著性（P〈0．01）。第Ⅱ组与第Ⅲ组之间差异无显著性（P〉0．05）。结论本研究示术毕时静脉注射昂丹司琼4mg与氟哌利多1．25mg均能有效防止、预防腹腔镜术后恶心呕吐。     

枢复宁灭吐灵和氟哌啶预防甲状腺术后恶心呕吐

枢复宁灭吐灵和氟哌啶预防甲状腺术后恶心呕吐孙来保＊何广芬＊谭洁芳＊陈秉学＊甲状腺腺瘤或甲状腺肿等择期手术病人９０例，麻醉采用一点颈丛法神经阻滞，双侧用药总量为０．３５％布比卡因２０ｍｌ。按辅助用药随机分５组：Ｎ组（１０例），为单纯局麻药阻滞；Ｄ组（２...     

体外循环下心肌缺血再灌注后血清心肌酶,SOD活性变化及复方…

２０例先天性室内隔或房间隔缺损患者，ＡＳＡⅡ￣Ⅲ级，麻醉后随机分为两组，组Ｉ为对照组（ｎ＝１０），组Ⅱ为复方丹参治疗组（ｎ＝１０）。组Ⅱ于手术开始前及复温后心脏复跳前分别静脉注射复方丹参２００ｍｇ／ｋｇ。结果表明，组Ｉ缺血（Ｔ２）及再灌注后各期血清乳酸脱氢酶（ＬＤＨ）、肌酸激酶（ＣＫ）与术前（Ｔ０）比较显著增高，而超氧化物岐化酶（ＳＯＤ）明显下降，与组Ⅱ各时期值有显著差异，且术后心功能恢复较组Ⅱ差     

多沙普仑,纳洛酮,氨茶碱用于全麻催醒的初步观察

全麻患者早期清醒减少术后并发症，我们用多沙普仑、纳洛酮、氨茶碱作全麻催醒，观察发现三者催醒效率无明显差异，常用量下较少毒副作用，报道如下。资料和方法选择术前血压、心、肺、肝、肾功能正常，无水、电解质、酸碱平衡失调的患者４０例，其中男２２例，女１８例，年龄１８～６８岁。将其随机分成四组：Ａ组（ｎ＝１２）：多沙普仑１～２ｍｇ／ｋｇ，Ｂ组（ｎ＝１０）：纳洛酮０．２～０．４ｍｇ，Ｃ组（ｎ＝１０）：氨茶碱２．０～２．５ｍｇ／ｋｇ，催醒用药均用１０％葡萄糖稀释成２０ｍｌ缓慢静注。Ｄ组（ｎ＝８）：对照组生理盐…     

Ondansetron, orally disintegrating tablets versus intravenous injection for prevention of intrathecal morphine-induced nausea, vomiting, and pruritus in young males

In this study we compared the efficacy of orally disintegrating tablets (ODT) and IV ondansetron for preventing spinal morphine-induced pruritus and postoperative nausea and vomiting (PONV) in healthy young male patients. Patients who received bupivacaine with 0.20 mg morphine for spinal anesthesia were randomly assigned to the ODT group (ODT ondansetron 8 mg, n = 50), the IV group (4 mg ondansetron IV, n = 50), or the placebo group (n = 50). Each individual was assessed for pruritus, postoperative nausea and vomiting, and pain at 0, 2, 6, 12, 18, and 24 h after surgery using three distinct visual analog scales. The frequencies of postoperative nausea and vomiting and frequencies of requirement for rescue antiemetic and antipruritic were recorded. There were no significant differences among the three groups with respect to incidence or severity of PONV or postoperative pain visual analog scale scores. The incidences of pruritus in the ODT (56%) and IV (66%) groups were significantly different from that in the placebo group (86%) (P < 0.02 for both). Only the ODT group had significantly lower mean pruritus visual analog scale scores at 0, 2, 6, and 12 h postsurgery than the placebo group (P < 0.023 for all). The frequency of requirement for rescue antipruritic was significantly less in the ODT group than the placebo group (P = 0.013). Both ODT ondansetron 8 mg and IV ondansetron 4 mg are more effective than placebo for preventing spinal morphine-induced pruritus, but neither form of this agent reduces spinal morphine-induced postoperative nausea and vomiting in this patient group.     

Comparison of ondansetron with ondansetron and dexamethasone in prevention of PONV in diagnostic laparoscopy

PURPOSE: To compare the efficacy of ondansetron-dexamethasone combination with ondansetron alone for prevention of postoperative nausea and vomiting (PONV). METHODS: This double blind, randomized study was carried out in 51 female patients, aged 20-40 yr, ASA-1 physical status undergoing gynecological diagnostic laparoscopy. Group 1 (n = 26) received 4 mg ondansetron i.v. and group 2 (n = 25) received a combination of 4 mg ondansetron and 8 mg dexamethasone i.v. soon after induction of anesthesia. Postoperatively patients were assessed hourly for four hours and then at 24 hr for nausea, vomiting, pain and post anesthetic discharge score. Vomiting occurring up to two hours was considered early vomiting and from 2-24 hr as delayed vomiting. RESULTS: The postoperative nausea score was lower in patients receiving a combination of ondansetron and dexamethasone (3.76) than ondansetron alone (4.38) at 0 hr (P < 0.01), 2 hr (P < 0.05) and 24 hr (P < 0.01). In group 1, 38.5% of patients had a nausea score of > or = 5 (major nausea) compared with only 12% of patients in group 2 (P < 0.025). The overall incidence of vomiting was greater in group 1 (35%) than in group 2 (8%) (P < 0.05). The combination group showed better control of delayed vomiting compared with the ondansetron group (4% vs 35%) (P < 0.01). CONCLUSION: The combination of ondansetron and dexamethasone provides adequate control of PONV, with delayed PONV being better controlled than early PONV.     

Postoperative nausea and vomiting in patients undergoing total abdominal hysterectomy under spinal anaesthesia: a randomized study of ondansetron prophylaxis

BACKGROUND AND OBJECTIVE: Patients undergoing total abdominal hysterectomy under general anaesthesia have a high risk of developing postoperative nausea and vomiting (PONV). The aim of this study was to evaluate the incidence of PONV in patients undergoing total abdominal hysterectomy under spinal anaesthesia with intravenous patient-controlled analgesia (PCA) using morphine and to compare its incidence with and without antiemetic prophylaxis. METHODS: Thirty-four patients undergoing total abdominal hysterectomy under spinal anaesthesia with i.v. PCA morphine postoperatively were divided into two groups. The first (n = 17) received ondansetron prophylaxis near the end of surgery while the second (n = 17) received no prophylaxis. Morphine consumption, emetic episodes (on a 3-point scale), patient satisfaction (visual analogue score), sedation and pruritus were evaluated 2, 4, 6, 9, 12, 18 and 24h postoperatively. RESULTS: Patient characteristics, postoperative morphine consumption (43.3 +/- 7.6 vs. 40.3 +/- 12.3 mg) and peristaltic recovery time (16.9 +/- 5 vs. 18.4 +/- 5.2 h) were similar in both groups. Overall nausea and vomiting were significantly lower in the ondansetron prophylaxis group than in the group without prophylaxis (52.9% vs. 88.2%, P < 0.05). Though nausea alone was higher in the prophylaxis group (41.2% vs. 29.4%), nausea with vomiting was significantly lower in the prophylaxis group (11.8% vs. 58.8%, P < 0.01). Patients' satisfaction scores were higher in the ondansetron group at all times and the difference was significant (P < 0.05) 4 h postoperatively. CONCLUSIONS: The incidence of PONV in patients undergoing total abdominal hysterectomy under spinal anaesthesia with i.v. PCA morphine is very high (88.2%). Antiemetic prophylaxis with ondansetron is highly recommended in this patients group resulting in a lower incidence of nausea and vomiting, and significantly improves patient' satisfaction and life quality in the early postoperative period.     

Comparison of ondansetron and droperidol in the prevention of postoperative nausea and vomiting after laparoscopic surgery in women

Background : Women undergoing laparoscopic surgery are susceptible to postoperative nausea and vomiting (PONV). Ondansetron and droperidol are useful antiemetics. This study was designed to ascertain primarily the relative difference in efficacy of ondansetron and droperidol and secondarily between these drugs and placebo in the prevention of PONV after laparoscopic surgery. Methods : The prophylactic antiemetic efficacy of ondansetron and droperidol was compared in a prospective, randomised, double–blind, placebo–controlled trial of 439 female inpatients scheduled for laparoscopic surgery. During induction of standardised general anaesthesia the patients received intravenously either ondansetron 8 mg (n=195), droperidol 1.25 mg (n=193) or placebo (n=51). The occurrence of nausea, vomiting, sideeffects and the need for rescue antiemetic medication were recorded for 24 h postoperatively. Results : The proportion of patients with nausea was 48%, 50% and 67% in the ondansetron, droperidol and placebo groups, respectively; with a significant difference when both ondansetron (P=0.02) and droperidol (P=0.04) were compared with placebo. Vomiting occurred in 18%, 26% and 37% of the patients in the three groups, respectively (P=0.05 between ondansetron and droperidol, P=0.004 between ondansetron and placebo, P=0.16 between droperidol and placebo). The proportion of patients given rescue medication was 34%, 28% and 49%, respectively (P=0.23 for ondansetron and droperidol, P=0.07 for ondansetron and placebo, P=0.007 for droperidol and placebo). During early recovery the patients treated with ondansetron were significantly more alert than after droperidol. Serious side–effects were not observed. Headache was significantly more common after ondansetron than after droperidol treatment. Conclusions : The efficacy of prophylactic ondansetron and droperidol in reducing postoperative nausea associated with laparoscopic surgery in female inpatients was similar, but ondansetron appeared to be slightly more efficient than droperidol in preventing vomiting. Ondansetron and droperidol were both significantly better than placebo in the prophylaxis of PONV.     

Effect of prophylactic ondansetron on postoperative nausea and vomiting in patients on preoperative steroids undergoing craniotomy for supratentorial tumors

The exact incidence of postoperative nausea and vomiting (PONV) in patients on steroids undergoing neurosurgical procedures is not known. This prospective randomized double-blind study was planned to know the efficacy of prophylactic ondansetron in the prevention of PONV in patients on steroids as compared with placebo. Seventy adult patients of either sex who had received preoperative steroids (dexamethasone) for at least 24 hours and were scheduled to undergo craniotomy for supratentorial tumors were included. Patients were randomly allocated using a randomization chart to 1 of the 2 groups to receive either ondansetron 4 mg (group O) or 0.9% saline (group S) intravenously at the time of dural closure. Numeric Rating Scale score for nausea and pain intensity was recorded preoperatively and till 24 hours postoperatively. The 6-hour postoperative nausea score was significantly lower in group O [median, 0; interquartile range (IQR), 0 to 20] than in group S (median, 20; IQR, 0 to 20) (P<0.05). The incidence of vomiting was lower in group O (23%) than in group S (46%) (P<0.05). The total number of emetic episodes, the number of doses of rescue antiemetics given in the first 6 postoperative hours, and the total number of rescue antiemetics given were significantly lower in group O than in group S (P<0.05). Intravenous administration of 4 mg of ondansetron at the time of dural closure was effective in reducing the incidence of PONV and the rescue antiemetics requirement in patients on preoperative steroids undergoing craniotomy for supratentorial tumors.     

A randomized controlled comparison of electro-acupoint stimulation or ondansetron versus placebo for the prevention of postoperative nausea and vomiting

In this study we evaluated the efficacy of electro-acupoint stimulation, ondansetron versus placebo for the prevention of postoperative nausea and vomiting (PONV). Patients undergoing major breast surgery under general anesthesia were randomized into active electro-acupoint stimulation (A), ondansetron 4 mg IV (O), or sham control (placement of electrodes without electro-acupoint stimulation; placebo [P]). The anesthetic regimen was standardized. The incidence of nausea, vomiting, rescue antiemetic use, pain, and patient satisfaction with management of PONV were assessed at 0, 30, 60, 90, 120 min, and at 24 h. The complete response (no nausea, vomiting, or use of rescue antiemetic) was significantly more frequent in the active treatment groups compared with placebo both at 2 h (A/O/P = 77%/64%/42%, respectively; P = 0.01) and 24 h postoperatively (A/O/P = 73%/52%/38%, respectively; P = 0.006). The need for rescue antiemetic was less in the treatment groups (A/O/P = 19%/28%/54%; P = 0.04). Specifically, the incidence and severity of nausea were significantly less in the A group compared with the other groups, and in the O group compared with the P group (A/O/P = 19%/40%/79%, respectively). The A group experienced less pain in the postanesthesia care unit, compared with the O and P groups. Patients in the treatment groups were more satisfied with their management of PONV compared with placebo. When used for the prevention of PONV, electro-acupoint stimulation or ondansetron was more effective than placebo with greater degree of patient satisfaction, but electro-acupoint stimulation seems to be more effective in controlling nausea, compared with ondansetron. Stimulation at P6 also has analgesic effects.     

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 following breast surgery. The efficacy of ondansetron and droperidol in preventing post-operative nausea and vomiting in women undergoing breast surgery was compared in this randomized, double-blind, placebo-controlled study. Altogether 207 women were randomly assigned to receive either a single intravenous dose of droperidol (1.25 mg) (n = 69), ondansetron (8 mg) (n = 67) or saline (n = 71) immediately after induction of general anaesthesia with thiopental, fentanyl, atracurium, nitrous oxide in oxygen and isoflurane. Complaints of nausea, vomiting and requests for rescue antiemetics were recorded during a 24-h period postoperatively. During the initial 2 h in the postanaesthesia care unit, the incidence of postoperative nausea and vomiting was 15%, 6% and 12% in the placebo, droperidol and ondansetron groups, respectively (NS). The incidence of post-operative nausea and vomiting during the first 24 h was 61%, 48% and 45% in the placebo, droperidol and ondansetron 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 prevent postoperative nausea and vomiting after breast surgery.     

Tropisetron vs ondansetron for prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy: a randomized double-blind,placebo-controlled study

Background: Postoperative nausea and vomiting are observed in increased frequency after laparoscopic surgery. This study was performed in order to compare the efficacy of two 5-hydroxytryptamine-3 (5-HT3) receptor antagonists, ondansetron and tropisetron, in preventing postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy. Methods: Using a randomized, double-blind study design, 87 ASA I and II patients scheduled for laparoscopic cholecystectomy were randomly assigned to receive 4 mg ondansetron (Group A, n = 29), 5 mg tropisetron (Group B, n = 31), or placebo (Group C, n = 27) intravenously (IV) before induction of anesthesia. The end points evaluated were frequency of nausea, nausea intensity rated on a scale from 1 (mild) to 5 (most severe), frequency of vomiting, and need for rescue antiemetics. These parameters were measured immediately after surgery (0 h), at 3 h, 6 h, and 12 h postoperatively. Results: The frequency of nausea was significantly higher in group A (31.2%) compared to group B (14%) at 12 h postoperatively (p <0.01). However, patients of group A had significantly lower nausea scores at 3 h postoperatively compared to group B. Postoperative vomiting occurred in 13.8% of patients in group A and 9.6% of patients in group B throughout the whole study period (p = n.s.). The need for rescue antiemetics was similar between groups A and B. Both groups were superior to placebo concerning all studied parameters. Conclusion: Our results show that ondansetron may be more effective in controlling nausea intensity during the first 3 h after laparoscopic cholecystectomy, while tropisetron has a longer-acting activity, with a major impact on nausea frequency at 12 h postoperatively.     

Prophylactic antiemetic efficacy of granisetron or ramosetron in patients undergoing thyroidectomy

OBJECTIVE: Thyroidectomy is associated with a high incidence of postoperative nausea and vomiting (PONV), ranging from 60% to 84%. We conducted this study to compare the antiemetic effects and safety of granisetron 20 micro g/kg and ramosetron 4 micro g/kg in patients undergoing elective thyroidectomy under standard anaesthetic technique. METHODS: One hundred and thirteen patients were randomized to receive placebo (n = 41), granisetron 20 nug/kg (n = 36) or ramosetron 4 micro g/kg (n = 36) intravenously over 2-5 minutes immediately before the induction of anaesthesia. The incidence of PONV, nausea severity score (NSS), adverse events and the need for rescue antiemetics were assessed during the first 1 hour (0-1 h) and following 23 hours (1-24 h) after anaesthesia. RESULTS: During the first hour after anaesthesia, the incidence of PONV was 36.6% for placebo, 11.1% for granisetron (p = 0.012 vs placebo) and 25.0% for ramosetron. During 1 hour to 23 hours after anaesthesia, the incidence of PONV was 51.2% for placebo, 30.6% for granisetron and 41.7% for ramosetron. There were no significant differences between the three groups. Overall (0-24 h), the corresponding incidence of PONV were 61.0%, 30.6% and 50.0%, respectively, showing a significantly lower value in the granisetron group than in the placebo group (p = 0.008). The incidence of vomiting and rescue antiemetic requirement during the first 24 hours after anaesthesia was significantly lower with the granisetron group than with placebo (p = 0.021 and 0.030, respectively). The most common adverse events in the three groups were headache and dizziness. CONCLUSION: Only granisetron 20 micro g/kg was superior to placebo for the prevention of PONV after thyroidectomy.     

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 double-blind, randomized, placebo-controlled study for the prevention of postoperative nausea and vomiting (PONV) for 24 h after day-case gynaecological laparoscopy. Compared with placebo (n = 58), ondansetron (n = 60) and cyclizine (n = 57) reduced significantly the incidence of moderate or severe nausea (30% and 23% vs 52%; P = 0.02 and P = 0.001, respectively) and requirement for escape antiemetic (28% and 16% vs 47%; P = 0.04 and P < 0.001, respectively) before discharge from hospital. There were no significant differences in PONV after discharge. Significantly more patients suffered no PONV before and after discharge after ondansetron and cyclizine compared with placebo (31% and 33% vs 12%; P = 0.02 and P < 0.01, respectively). For diagnostic laparoscopy (n = 74), fewer patients received escape antiemetic after cyclizine than after ondansetron (4% vs 37%; P < 0.01); for laparoscopic sterilization (n = 101), both antiemetics were equally effective. Ondansetron and cyclizine both reduced severe and moderate nausea and the need for antiemetic therapy after day-case gynaecological laparoscopy.