Postoperative nausea and vomiting after sevoflurane with or without ondansetron compared with propofol in female patients undergoing breast surgery.

IMPLICATIONS: We studied 180 female patients undergoing breast surgery. The patients were randomly allocated to receive one of three anesthetic techniques. Compared with either propofol or sevoflurane alone, sevoflurane with ondansetron resulted in a decreased incidence of postoperative nausea and vomiting. Sevoflurane with ondansetron prophylaxis is a good alternative to propofol with respect to avoiding postoperative nausea and vomiting.

Intravenous ketoprofen for pain relief after total hip or knee replacement.

BACKGROUND: There are few studies in which ketoprofen, a propionic acid derivate NSAID, has been tested as an intravenous postoperative analgesic. The aim of this double-blind, randomized, placebo-controlled work was to study the tolerability and efficacy of intravenous ketoprofen in seventy-six patients undergoing hip or knee total endoprothesis surgery using three different doses. METHODS: The patients received either ketoprofen 50 mg, 100 mg or 150 mg, or placebo as an initial intravenous loading, followed by an infusion containing 50 mg, 100 mg or 150 mg or placebo, respectively, over the following eleven and a half hours. The consumption of fentanyl was recorded and the patients assessed their pain intensity on a 10-cm visual analogue scale (VAS) at 0, 2, 4 and 12 hours. Possible side-effects were recorded at the same intervals. RESULTS: Patients receiving ketoprofen showed significantly lower total fentanyl consumption and significantly better pain relief at 12 hours was achieved by a 300 mg dose of ketoprofen than by placebo. Side-effects were minimal, with no differences between the groups. CONCLUSION: A bolus of ketoprofen following continuous infusion of ketoprofen, coupled with a PCA-system, was an effective and safe approach for the relief of postoperative pain.

Antiemetic efficacy of prophylactic ondansetron in laparoscopic cholecystectomy. A randomised, double-blind, placebo-controlled trial.

The antiemetic efficacy of ondansetron given prophylactically was investigated in a randomised, double-blind, placebo-controlled trial of 63 patients undergoing laparoscopic cholecystectomy. The patients received intravenously prior to anaesthesia either ondansetron 4 mg or placebo. The same standardised general anaesthetic technique was used. Nausea, emetic episodes and the need for rescue medication were recorded for 24 h postoperatively. Nausea was experienced by 64% of the patients in the ondansetron group and 56% in the placebo group, and emetic episodes occurred in 45% and 50% of the patients in the two groups, respectively. The proportions of patients given rescue antiemetic medication were 45% and 44%, respectively. No clinically important adverse events were observed. In conclusion, ondansetron given prior to anaesthesia in a dosage of 4 mg did not prevent postoperative nausea and vomiting after laparoscopic cholecystectomy.