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Rev Bras Anestesiol · Jan 2008
Comparative Study Controlled Clinical TrialProphylactic antiemetic therapy for acute abdominal surgery. A comparative study of droperidol, metoclopramide, tropisetron, granisetron and dexamethasone.
- Víctor Contreras-Domínguez and Paulina Carbonell-Bellolio.
- Serviço de Urgências, Hospital Clínico Regional de Concepción, Universidade de Concepción, Concepción, Chile. viccontredom@yahoo.com
- Rev Bras Anestesiol. 2008 Jan 1;58(1):35-44.
Background And ObjectivesIt is calculated that the incidence of postoperative nausea and vomiting (PONV) is approximately 30%. The prophylaxis of PONV has been the subject of several studies, both to decrease this problem and to compare the cost-benefit ration of the treatment used. The objective of this study was to compare the efficacy of 5 antiemetic drugs with a control group in emergency appendectomy.MethodsA controlled, double-blind, prospective study with 150 patients, ASA I and II, BMI < 30, undergoing appendectomy, was undertaken. Patients were divided in six groups: Group 1 (n = 25): 5 mL of normal saline; Group 2 (n = 25): 0.625 mg of droperidol; Group 3 (n = 25): 20 mg of metoclopramide; Group 4 (n = 25): 5 mg of tropisetron; Group 5 (n = 25): 1 mg of granisetron; Group 6 (n = 25): 4 mg of dexamethasone. Monitoring included ECG non-invasive blood pressure, O2 saturation, P(ET)CO2, anesthetic gas analyzer and peripheral nerve stimulator. The presence of PONV complications and the degree of satisfaction in the first 48 hours were evaluated.ResultsThe incidence of PONV in the droperidol group was 4% while in the granisetron, tropisetron and metoclopramide groups it was 12% (p < 0.05). The dexamethasone group had a 24% incidence and the control group 28%.ConclusionsLow doses of droperidol were more effective in the prophylaxis of PONV in emergency appendectomy than the other drugs.
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