• Onur Koyuncu, Steve Leung, Jing You, Menekse Oksar, Selim Turhanoglu, Cagla Akkurt, Kenan Dolapcioglu, Hanifi Sahin, Daniel I Sessler, and Alparslan Turan.
• Department of Anesthesiology, Department of Outcomes Research, Anesthesiology Institute, Mustafa Kemal University Tayfur Ata Sokmen Medicine Faculty, Hatay, Turkey. Electronic address: okoyuncu@mku.edu.tr.
• J Clin Anesth. 2017 Aug 1; 40: 78-83.

ObjectivesTo determine that perioperative ondansetron reduces the analgesic efficacy of acetaminophen.DesignRandomized, double-blinded study.Patients120 patients ASA I-II who underwent abdominal hysterectomy.InterventionsAll the patients were given 1g acetaminophen at skin closure. Patients were divided into two groups; ondansetron HCl (8mg, 2ml IV) (Group I, N=60) and saline (2ml IV) (Group II, N=60) at the skin closure.MeasurementPostoperative pain scores (VAS) while resting in bed and sitting, total opioid consumption were noted.Main ResultsPatients randomized to ondansetron had significantly worse pain scores upon arrival to the recovery unit [by 1.7 (99.7% CI: 0.75, 2.59) cm] and at 1h [by 1.3 (0.5, 2.1) cm] while resting in bed. Pain scores while sitting were also significantly greater in ondansetron group at arrival in PACU by 0.6 (99.7% CI: 0.1, 1.0) cm. Thereafter, pain scores did not differ significantly. Median total opioid (tramadol) consumption was 441 [Q1, Q3: 280, 578] mg in the ondansetron group and 412 [309, 574] mg in the placebo group, P=0.95.ConclusionsOndansetron significantly decreased the analgesic effect of acetaminophen during the initial postoperative period. Our results thus confirm that acetaminophen analgesia is partially mediated by serotonin receptors. However, the reduction was of marginal clinical importance and short-lived.Copyright © 2017 Elsevier Inc. All rights reserved.

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