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Prophylaxis of postoperative nausea and vomiting with oral, long-acting dimenhydrinate in gynecologic outpatient laparoscopy.
Anesth Analg. 2004 Jun; 98(6):1660-4, table of contents.A&A

Abstract

Dimenhydrinate is an inexpensive antiemetic with few side effects available as an oral, long-acting (LA) formulation (Gravol L/A) containing 25 mg of immediate and 50 mg of sustained release drug. We designed this double-blind comparison trial to assess the efficacy of dimenhydrinate LA versus droperidol alone and the combination for prophylaxis of nausea, vomiting, and retching in outpatient gynecologic laparoscopy. One-hundred-forty-one women were randomized into 3 groups: 1) droperidol (placebo capsule preoperatively and IV droperidol 0.625 mg before induction), 2) dimenhydrinate LA preoperatively and IV placebo before induction, or 3) combination. Information regarding nausea, vomiting, retching, pain, and sedation was recorded in the postanesthesia care unit (PACU) and collected by telephone for the presence of symptoms: on arrival home; at bedtime; upon arising, and at lunchtime the following day. The overall incidence of complete treatment failure (rescue medication in PACU or nausea, vomiting, or retching at any time point) was 28 of 46 (61%), 28 of 48 (58%), and 22 of 47 (47%); and for treatment failure vomiting (rescue medication in PACU or vomiting or retching at any time point) was 16 of 46 (35%), 11 of 48 (23%), and 5 of 47 (11%), for the droperidol, dimenhydrinate, and combination groups, respectively (P = 0.007 for droperidol versus combination). There were no differences in sedation or pain. Preoperative administration of an oral dose of LA dimenhydrinate in combination with droperidol when compared with droperidol alone effectively reduced the incidence of vomiting but not nausea in women undergoing elective outpatient gynecologic laparoscopy.

IMPLICATIONS

Dimenhydrinate is an inexpensive antiemetic with few side effects available as a long-acting oral formulation. Women undergoing outpatient gynecologic laparoscopy were given droperidol, an effective antiemetic, dimenhydrinate alone, or the combination of the two drugs. Dimenhydrinate plus droperidol significantly reduced the overall incidence of vomiting, but not nausea, when compared with droperidol alone.

Authors+Show Affiliations

Department of Anesthesiology, Queen's University, Kingston General Hospital, 76 Stuart Street, Kingston, Ontario, Canada K7L 2S6. ket1@post.queensu.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15155323

Citation

Turner, Kim E., et al. "Prophylaxis of Postoperative Nausea and Vomiting With Oral, Long-acting Dimenhydrinate in Gynecologic Outpatient Laparoscopy." Anesthesia and Analgesia, vol. 98, no. 6, 2004, 1660-4, table of contents.
Turner KE, Parlow JL, Avery ND, et al. Prophylaxis of postoperative nausea and vomiting with oral, long-acting dimenhydrinate in gynecologic outpatient laparoscopy. Anesth Analg. 2004;98(6):1660-4, table of contents.
Turner, K. E., Parlow, J. L., Avery, N. D., Tod, D. A., & Day, A. G. (2004). Prophylaxis of postoperative nausea and vomiting with oral, long-acting dimenhydrinate in gynecologic outpatient laparoscopy. Anesthesia and Analgesia, 98(6), 1660-4, table of contents.
Turner KE, et al. Prophylaxis of Postoperative Nausea and Vomiting With Oral, Long-acting Dimenhydrinate in Gynecologic Outpatient Laparoscopy. Anesth Analg. 2004;98(6):1660-4, table of contents. PubMed PMID: 15155323.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prophylaxis of postoperative nausea and vomiting with oral, long-acting dimenhydrinate in gynecologic outpatient laparoscopy. AU - Turner,Kim E, AU - Parlow,Joel L, AU - Avery,Nicole D, AU - Tod,Deborah A, AU - Day,Andrew G, PY - 2004/5/25/pubmed PY - 2004/7/15/medline PY - 2004/5/25/entrez SP - 1660-4, table of contents JF - Anesthesia and analgesia JO - Anesth. Analg. VL - 98 IS - 6 N2 - UNLABELLED: Dimenhydrinate is an inexpensive antiemetic with few side effects available as an oral, long-acting (LA) formulation (Gravol L/A) containing 25 mg of immediate and 50 mg of sustained release drug. We designed this double-blind comparison trial to assess the efficacy of dimenhydrinate LA versus droperidol alone and the combination for prophylaxis of nausea, vomiting, and retching in outpatient gynecologic laparoscopy. One-hundred-forty-one women were randomized into 3 groups: 1) droperidol (placebo capsule preoperatively and IV droperidol 0.625 mg before induction), 2) dimenhydrinate LA preoperatively and IV placebo before induction, or 3) combination. Information regarding nausea, vomiting, retching, pain, and sedation was recorded in the postanesthesia care unit (PACU) and collected by telephone for the presence of symptoms: on arrival home; at bedtime; upon arising, and at lunchtime the following day. The overall incidence of complete treatment failure (rescue medication in PACU or nausea, vomiting, or retching at any time point) was 28 of 46 (61%), 28 of 48 (58%), and 22 of 47 (47%); and for treatment failure vomiting (rescue medication in PACU or vomiting or retching at any time point) was 16 of 46 (35%), 11 of 48 (23%), and 5 of 47 (11%), for the droperidol, dimenhydrinate, and combination groups, respectively (P = 0.007 for droperidol versus combination). There were no differences in sedation or pain. Preoperative administration of an oral dose of LA dimenhydrinate in combination with droperidol when compared with droperidol alone effectively reduced the incidence of vomiting but not nausea in women undergoing elective outpatient gynecologic laparoscopy. IMPLICATIONS: Dimenhydrinate is an inexpensive antiemetic with few side effects available as a long-acting oral formulation. Women undergoing outpatient gynecologic laparoscopy were given droperidol, an effective antiemetic, dimenhydrinate alone, or the combination of the two drugs. Dimenhydrinate plus droperidol significantly reduced the overall incidence of vomiting, but not nausea, when compared with droperidol alone. SN - 0003-2999 UR - https://www.unboundmedicine.com/medline/citation/15155323/Prophylaxis_of_postoperative_nausea_and_vomiting_with_oral_long_acting_dimenhydrinate_in_gynecologic_outpatient_laparoscopy_ L2 - http://dx.doi.org/10.1213/01.ane.0000117288.76432.7f DB - PRIME DP - Unbound Medicine ER -