Prophylactic iv ondansetron reduces nausea, vomiting and pruritus following epidural morphine for postoperative pain control.

Author(s): Tzeng JI, Chu KS, Ho ST, Cheng KI, Liu KS, Wang JJ

Affiliation(s): Departments of Medical Research and Anesthesiology, Chi-Mei Medical Center, Tainan, Taiwan.

Publication date & source: 2003-12, Can J Anaesth., 50(10):1023-6.

Publication type: Clinical Trial; Randomized Controlled Trial

PURPOSE: To evaluate the prophylactic effect of ondansetron on nausea and vomiting following epidural morphine for postoperative pain control. METHODS: Seventy women (n = 35 in each group) undergoing abdominal total hysterectomy under epidural anesthesia were enrolled in this randomized, double-blinded, and placebo-controlled study. At the end of surgery, all patients received epidural morphine 3 mg for postoperative pain relief. Before morphine injection, the ondansetron group received iv ondansetron 4 mg, whereas the placebo group received iv saline. RESULTS: Patients in the ondansetron group reported a lower frequency of total postoperative nausea and vomiting (22%) and lower frequency of rescue antiemetic request (12%) than those in the placebo group (52% and 39%, respectively; P < 0.05). In addition, ondansetron was associated with a reduced incidence of pruritus following epidural morphine (28% vs 58%; P < 0.05). CONCLUSION: We conclude that iv ondansetron 4 mg is effective in the prevention of nausea, vomiting, and pruritus following epidural morphine for postoperative pain control.