Transdermal scopolamine patch in addition to ondansetron for postoperative nausea and vomiting prophylaxis in patients undergoing ambulatory cosmetic surgery.

Author(s): Sah N, Ramesh V, Kaul B, Dalby P, Shestak K, Vallejo MC

Affiliation(s): Department of Anesthesiology, Magee Womens Hospital and the University of Pittsburgh, Pittsburgh, PA 15213, USA. sahxnb@anes.upmc.edu

Publication date & source: 2009-06, J Clin Anesth., 21(4):249-52. Epub 2009 Jun 6.

Publication type: Randomized Controlled Trial

STUDY OBJECTIVE: To determine the efficacy of transdermal scopolamine in addition to ondansetron in decreasing the incidence of postoperative nausea and vomiting (PONV). DESIGN: Randomized controlled trial. SETTING: Academic hospital. PATIENTS: 126 ASA physical status I and II patients undergoing outpatient plastic surgery with three or more risk factors for PONV. INTERVENTIONS: Patients were randomly assigned to one of two groups to receive (Group 1) a transdermal scopolamine (TDS) patch or (Group 2), a placebo patch two hours before surgery. MEASUREMENTS: Occurrence of vomiting, severity of nausea using a visual analog scale (VAS), rescue medication, pain intensity and pain medications, and side effects were recorded every hour until discharge from hospital, then every 4 hours thereafter for a total of 24 hours. MAIN RESULTS: A statistically significant reduction in postoperative nausea between 8 and 24 hours in patients receiving TDS was noted. CONCLUSIONS: Transdermal scopolamine in addition to ondansetron benefits patients at high risk for PONV undergoing outpatient plastic surgery for up to 20 hours after surgery.