Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942001000500005
Brazilian Journal of Anesthesiology
Scientific Article

Eficácia do ondansetron e da alizaprida na prevenção de náusea e vômito em laparoscopia ginecológica

Efficacy of ondansetron and alizapride in preventing gynecological laparoscopy nausea and vomiting

Eliana M Ganem; Paula Fabris; Marlene Z Moro; Yara Marcondes Machado Castiglia

Downloads: 0
Views: 933

Resumo

JUSTIFICATIVA E OBJETIVOS: A laparoscopia ginecológica é procedimento que determina alta incidência de náusea e vômito no pós-operatório. Este estudo teve por finalidade comparar a eficácia do ondansetron e da alizaprida na prevenção de náusea e vômito em pacientes submetidas à laparoscopia ginecológica. MÉTODO: Participaram do estudo 52 pacientes, estado físico ASA I ou II, com idades entre 21 e 50 anos, sem queixas gástricas prévias, submetidas à laparoscopia para diagnóstico ou cirurgia. As pacientes foram divididas em 2 grupos: o grupo 1 recebeu ondansetron (4 mg) e o grupo 2, alizaprida (50 mg), por via venosa, antes da indução da anestesia. Todas as pacientes receberam midazolam (7,5 mg) por via oral como medicação pré-anestésica, sufentanil (0,5 µg.kg-1) e propofol (2 mg.kg-1) para indução, propofol (115 µg.kg-1) e N2O/O2 em fração inspirada de O2 a 40% para manutenção e atracúrio (0,5 mg.kg-1) como bloqueador neuromuscular. A analgesia pós-operatória foi realizada com cetoprofeno (100 mg) e buscopam composto®. RESULTADOS: Ambos os grupos foram idênticos quanto aos dados antropométricos e à duração da cirurgia e da anestesia. No grupo 1 (n=27) uma paciente apresentou náusea, No grupo 2, uma paciente apresentou náusea e três vomitaram, resultados estatisticamente não significativos. CONCLUSÕES: O ondansetron e a alizaprida foram similares na prevenção de náusea e vômito em pacientes submetidas à laparoscopia ginecológica.

Palavras-chave

ANTIEMÉTICOS, ANTIEMÉTICOS, CIRURGIA, Ginecológica, COMPLICAÇÕES, COMPLICAÇÕES

Abstract

BACKGROUND AND OBJECTIVES: Gynecological laparoscopy is a procedure with a high incidence of postoperative nausea and vomiting (PONV). This study aimed at comparing the efficacy of ondansetron and alizapride in preventing PONV in patients submitted to gynecological laparoscopy. METHODS: Participated in this study 52 women physical status ASA I and II, aged 21 to 50 years, without previous gastric complaint, who were submitted to diagnostic or surgical laparoscopy. Patients were distributed in 2 groups: Group 1 - intravenous ondansetron (4 mg) and Group 2 - intravenous alizapride (50 mg), before anesthetic induction. All patients were premedicated with oral midazolam (7.5 mg), were induced with sufentanil (0,5 µg.kg-1) and propofol (2 mg.kg-1). Propofol (115 µg.kg-1) and N2O/O2 (F I O2 = 40%) were used for maintenance, and atracurium (0,5 mg.kg-1) was the neuromuscular blocker. Postoperative analgesia was achieved with cetoprofen (100 mg) and buscopam composto®. RESULTS: Both groups were identical in demographics and surgery and anesthesia duration. One Group 1 patient referred nausea. One Group 2 patients referred nausea and 3 referred vomiting, but results were not statistically significant. CONCLUSIONS: Ondansetron and alizapride were comparable in preventing PONV in patients submitted to gynecological laparoscopy.

Keywords

ANTIEMETICS, ANTIEMETICS, COMPLICATIONS, COMPLICATIONS, SURGERY, Gynecological

References

Watcha MF, White PF. Postoperative nausea and vomiting. Its etiology, treatment and prevention. Anesthesiology. 1992;77:162-184.

Cohen MM, Duncan PG, DeBoer DP. The postoperative interview: assessing risk factors for nausea and vomiting. Anesth Analg. 1994;78:7-16.

Okum GS, Colonna-Romano P, Horrow JC. Vomiting after alfentanil anesthesia: effect of dosing method. Anesth Analg. 1992;75:558-560.

Kapur PA. Editorial: The big "Little Problem". Anesth Analg. 1991;73:243-245.

Larsson S, Lundberg D. A prospective survey of postoperative nausea and vomiting with special regard to incidence and relations to patient characteristics, anesthetic routines and surgical procedures.. Acta Anaesthesiol Scand. 1995;39:539-545.

Grood PMRM, Harbers JBM, Egmond J. Anaesthesia for laparoscopy. Anaesthesia. 1987;42:815-823.

Raftery S, Sherry E. Total intravenous anaesthesia with propofol and alfentanil protects against postoperative nausea and vomiting. Can J Anaesth. 1992;39:37-40.

Green G, Jansson L. Nausea: the most important factor determining length of stay after ambulatory anaesthesia. A comparative study of isoflurane and/or propofol techniques.. Acta Anaesthesiol Scand. 1993;37:742-746.

Klockgether-Radke A, Piore KV, Crozier T. Nausea and vomiting after laparoscopic surgery: a comparison of propofol and thiopentone/halothane anaesthesia.. Eur J Anaesthesiol. 1996;13:3-9.

Pavlin DJ, Coda B, Shen DD. Effects of combining propofol and alfentanil on ventilation, analgesia, sedation, and emesis in human volunteers.. Anesthesiology. 1996;84:23-27.

Sniadach MS, Alberts MS. A comparison of the prophylactic antiemetic effect of ondansetron and droperidol on patients undergoing gynecologic laparoscopy.. Anesth Analg. 1997;85:797-800.

Naguib M, Bakry AKE, Khoshim MHB. Prophylactic antiemetic therapy with ondansetron, tropisetron, granisetron and metoclopramide in patients undergoing laparoscopic cholecystectomy: a randomized, double-blind comparison with placebo. Can J Anaesth. 1996;43:226-231.

Monagle J, Barnes R, Goodchild C. Ondansetron is not superior to moderate dose metoclopramide in the prevention of postoperative nausea and vomiting after minor gynaecological surgery.. Eur J Anaesthesiol. 1997;14:604-609.

Jokela R, Koivuranta M. Tropisetron or droperidol in the prevention of postoperative nausea and vomiting. Acta Anaesthesiol Scand. 1999;43:645-650.

Warrick PD, Belo SE. Treating "rebound" emesis following outpatient gynecologic laparoscopy: the efficacy of a two-dose regimen of droperidol and ondansetron.. J Clin Anesth. 1999;11:119-125.

Russel D, Kenny GNC. 5-HT3 antagonists in postoperative nausea and vomiting. Br J Anaesth. 1992;69(^s1):63-68.

Vanacker B, Aken HV. Alizapride in the prevention of postoperative vomiting. A double-blind comparison. Acta Anaesthesiol Belg. 1988;39:247-250.

Mckenzie R, Kovac A, O'Connor T. Comparison of ondansetron versus placebo to prevent postoperative nausea and vomiting in women undergoing ambulatory gynecologic surgery.. Anesthesiology. 1993;78:21-28.

Malins AF, Field JM, Nesling PM. Nausea and vomiting after gynaecological laparoscopy: comparison of premedication with oral ondansetron, metoclopramide and placebo. Br J Anaesth. 1994;72:231-233.

Suen TKL, Gin TA, Chen PP. Ondansetron 4 mg for the prevention of nausea and vomiting after minor laparoscopic gynaecological surgery. Anaesth Intensive Care. 1994;22:142-146.

Raphael JH, Norton AC. Antiemetic efficacy of prophylactic ondansetron in laparoscopic surgery: randomized, double-blind comparison with metoclopramide.. Br J Anaesth. 1993;71:845-848.

Booij LH, Rachmat S, Bulder ER. Alizapride in prevention to postoperative nausea and vomiting.. Neth J Surg. 1988;40:6-9.

Stienstra R, Samhan YM, El-Mofty M. Double-blind comparison of alizapride, droperidol and ondansetron in the treatment of post-operative nausea.. Eur J Anaesthesiol. 1997;14:290-294.

Beattie WS, Lindblad T, Buckley DN. The incidence of post-operative nausea and vomiting in women undergoing laparoscopy is influenced by the day menstrual cycle.. Can J Anaesth. 1991;38:298-302.

Beattie WS, Lindblad T, Buckley DN. Menstruation increases the risk of nausea and vomiting after laparoscopy.. Anesthesiology. 1993;78:272-276.

5dd7f2270e8825100913f286 rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections