The effect of timing of ondansetron administration in outpatients undergoing otolaryngologic surgery

Rui Sun, Kevin W. Klein, Paul F. White

Research output: Contribution to journalArticle

124 Citations (Scopus)

Abstract

A randomized, double-blind, placebo-controlled study was designed to compare the relative efficacy of prophylactic ondansetron, 4 mg intravenously (IV), when administered before induction of anesthesia or at the end of surgery to an outpatient population at high risk of developing postoperative nausea and vomiting (PONV). Patients undergoing otolaryngologic surgery were randomly assigned to one of three different treatment groups: Group I (placebo) received saline 5 mL prior to induction of anesthesia and again at the end of surgery; Group II received ondansetron 4 mg in 5 mL prior to induction of anesthesia and saline 5 mL at the end of surgery; and Group III received saline 5 mL prior to induction of anesthesia and ondansetron 4 mg at the end of surgery. All patients received the same general anesthetic technique. A standardized regimen of rescue antiemetics was administered in the recovery room to patients with ≤2 emetic episodes or at the patient's request for persistent nausea. Episodes of nausea and vomiting, as well as the need for rescue antiemetics, were recorded for 24 h after the operation. The incidences of nausea and emesis in the recovery room after prophylactic ondansetron, 4 mg IV, administered either before induction (68% and 20%, respectively) or at the end of surgery (60% and 4%, respectively) were not significantly decreased compared to the placebo control group (80% and 12%, respectively). However, when ondansetron was administered at the end of the operation, it significantly reduced the need for rescue antiemetics in the recovery room (36% vs 64% in the control group). The postanesthesia care unit and hospital discharge times were similar in all three study groups. One patient in Group II and one patient in Group III were hospitalized because of intractable symptoms related to PONV. After discharge from the ambulatory surgery unit, the incidence of nausea, vomiting, and the need for rescue antiemetic drugs were similar in all three treatment groups. In conclusion, ondansetron (4 mg IV) was more effective in reducing the need for rescue antiemetics in the recovery room when administered at the end versus prior to the start of otolaryngologic surgery. Therefore, when ondansetron is used for antiemetic prophylaxis in outpatients undergoing otolaryngologic procedures, it should be administered at the end of the operation rather than prior to induction of anesthesia.

Original languageEnglish (US)
Pages (from-to)331-336
Number of pages6
JournalAnesthesia and Analgesia
Volume84
Issue number2
DOIs
StatePublished - 1997

Fingerprint

Ondansetron
Antiemetics
Outpatients
Recovery Room
Anesthesia
Nausea
Vomiting
Postoperative Nausea and Vomiting
Placebos
Ambulatory Surgical Procedures
Emetics
General Anesthetics
Control Groups
Hospital Units
Incidence
Therapeutics

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

The effect of timing of ondansetron administration in outpatients undergoing otolaryngologic surgery. / Sun, Rui; Klein, Kevin W.; White, Paul F.

In: Anesthesia and Analgesia, Vol. 84, No. 2, 1997, p. 331-336.

Research output: Contribution to journalArticle

@article{5a34e667a9f44a0cbfa07108065633d7,
title = "The effect of timing of ondansetron administration in outpatients undergoing otolaryngologic surgery",
abstract = "A randomized, double-blind, placebo-controlled study was designed to compare the relative efficacy of prophylactic ondansetron, 4 mg intravenously (IV), when administered before induction of anesthesia or at the end of surgery to an outpatient population at high risk of developing postoperative nausea and vomiting (PONV). Patients undergoing otolaryngologic surgery were randomly assigned to one of three different treatment groups: Group I (placebo) received saline 5 mL prior to induction of anesthesia and again at the end of surgery; Group II received ondansetron 4 mg in 5 mL prior to induction of anesthesia and saline 5 mL at the end of surgery; and Group III received saline 5 mL prior to induction of anesthesia and ondansetron 4 mg at the end of surgery. All patients received the same general anesthetic technique. A standardized regimen of rescue antiemetics was administered in the recovery room to patients with ≤2 emetic episodes or at the patient's request for persistent nausea. Episodes of nausea and vomiting, as well as the need for rescue antiemetics, were recorded for 24 h after the operation. The incidences of nausea and emesis in the recovery room after prophylactic ondansetron, 4 mg IV, administered either before induction (68{\%} and 20{\%}, respectively) or at the end of surgery (60{\%} and 4{\%}, respectively) were not significantly decreased compared to the placebo control group (80{\%} and 12{\%}, respectively). However, when ondansetron was administered at the end of the operation, it significantly reduced the need for rescue antiemetics in the recovery room (36{\%} vs 64{\%} in the control group). The postanesthesia care unit and hospital discharge times were similar in all three study groups. One patient in Group II and one patient in Group III were hospitalized because of intractable symptoms related to PONV. After discharge from the ambulatory surgery unit, the incidence of nausea, vomiting, and the need for rescue antiemetic drugs were similar in all three treatment groups. In conclusion, ondansetron (4 mg IV) was more effective in reducing the need for rescue antiemetics in the recovery room when administered at the end versus prior to the start of otolaryngologic surgery. Therefore, when ondansetron is used for antiemetic prophylaxis in outpatients undergoing otolaryngologic procedures, it should be administered at the end of the operation rather than prior to induction of anesthesia.",
author = "Rui Sun and Klein, {Kevin W.} and White, {Paul F.}",
year = "1997",
doi = "10.1097/00000539-199702000-00016",
language = "English (US)",
volume = "84",
pages = "331--336",
journal = "Anesthesia and Analgesia",
issn = "0003-2999",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - The effect of timing of ondansetron administration in outpatients undergoing otolaryngologic surgery

AU - Sun, Rui

AU - Klein, Kevin W.

AU - White, Paul F.

PY - 1997

Y1 - 1997

N2 - A randomized, double-blind, placebo-controlled study was designed to compare the relative efficacy of prophylactic ondansetron, 4 mg intravenously (IV), when administered before induction of anesthesia or at the end of surgery to an outpatient population at high risk of developing postoperative nausea and vomiting (PONV). Patients undergoing otolaryngologic surgery were randomly assigned to one of three different treatment groups: Group I (placebo) received saline 5 mL prior to induction of anesthesia and again at the end of surgery; Group II received ondansetron 4 mg in 5 mL prior to induction of anesthesia and saline 5 mL at the end of surgery; and Group III received saline 5 mL prior to induction of anesthesia and ondansetron 4 mg at the end of surgery. All patients received the same general anesthetic technique. A standardized regimen of rescue antiemetics was administered in the recovery room to patients with ≤2 emetic episodes or at the patient's request for persistent nausea. Episodes of nausea and vomiting, as well as the need for rescue antiemetics, were recorded for 24 h after the operation. The incidences of nausea and emesis in the recovery room after prophylactic ondansetron, 4 mg IV, administered either before induction (68% and 20%, respectively) or at the end of surgery (60% and 4%, respectively) were not significantly decreased compared to the placebo control group (80% and 12%, respectively). However, when ondansetron was administered at the end of the operation, it significantly reduced the need for rescue antiemetics in the recovery room (36% vs 64% in the control group). The postanesthesia care unit and hospital discharge times were similar in all three study groups. One patient in Group II and one patient in Group III were hospitalized because of intractable symptoms related to PONV. After discharge from the ambulatory surgery unit, the incidence of nausea, vomiting, and the need for rescue antiemetic drugs were similar in all three treatment groups. In conclusion, ondansetron (4 mg IV) was more effective in reducing the need for rescue antiemetics in the recovery room when administered at the end versus prior to the start of otolaryngologic surgery. Therefore, when ondansetron is used for antiemetic prophylaxis in outpatients undergoing otolaryngologic procedures, it should be administered at the end of the operation rather than prior to induction of anesthesia.

AB - A randomized, double-blind, placebo-controlled study was designed to compare the relative efficacy of prophylactic ondansetron, 4 mg intravenously (IV), when administered before induction of anesthesia or at the end of surgery to an outpatient population at high risk of developing postoperative nausea and vomiting (PONV). Patients undergoing otolaryngologic surgery were randomly assigned to one of three different treatment groups: Group I (placebo) received saline 5 mL prior to induction of anesthesia and again at the end of surgery; Group II received ondansetron 4 mg in 5 mL prior to induction of anesthesia and saline 5 mL at the end of surgery; and Group III received saline 5 mL prior to induction of anesthesia and ondansetron 4 mg at the end of surgery. All patients received the same general anesthetic technique. A standardized regimen of rescue antiemetics was administered in the recovery room to patients with ≤2 emetic episodes or at the patient's request for persistent nausea. Episodes of nausea and vomiting, as well as the need for rescue antiemetics, were recorded for 24 h after the operation. The incidences of nausea and emesis in the recovery room after prophylactic ondansetron, 4 mg IV, administered either before induction (68% and 20%, respectively) or at the end of surgery (60% and 4%, respectively) were not significantly decreased compared to the placebo control group (80% and 12%, respectively). However, when ondansetron was administered at the end of the operation, it significantly reduced the need for rescue antiemetics in the recovery room (36% vs 64% in the control group). The postanesthesia care unit and hospital discharge times were similar in all three study groups. One patient in Group II and one patient in Group III were hospitalized because of intractable symptoms related to PONV. After discharge from the ambulatory surgery unit, the incidence of nausea, vomiting, and the need for rescue antiemetic drugs were similar in all three treatment groups. In conclusion, ondansetron (4 mg IV) was more effective in reducing the need for rescue antiemetics in the recovery room when administered at the end versus prior to the start of otolaryngologic surgery. Therefore, when ondansetron is used for antiemetic prophylaxis in outpatients undergoing otolaryngologic procedures, it should be administered at the end of the operation rather than prior to induction of anesthesia.

UR - http://www.scopus.com/inward/record.url?scp=0031046006&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031046006&partnerID=8YFLogxK

U2 - 10.1097/00000539-199702000-00016

DO - 10.1097/00000539-199702000-00016

M3 - Article

C2 - 9024023

AN - SCOPUS:0031046006

VL - 84

SP - 331

EP - 336

JO - Anesthesia and Analgesia

JF - Anesthesia and Analgesia

SN - 0003-2999

IS - 2

ER -