Dose-response Study Of Ondanseton In The Prevention Of Postoperative Nausea And Vomiting After Laparoscopic Cholecystectomy

Objectve:To compare the prophylactic effects of ondansetron on postoperative nausea and vomiting (PONV) after laparoscopic Cholecystectomy (LC). Methods:one hundred and forty ASAâ… -â…¡women aged 30 to 60 years scheduled for LC were randomly divided into seven groups with twenty cases each. The patients were intubated by propofol, fentanyl and atracurium, and anesthesia were maintained with inhalation of sevoflurane, fentanyl and atracurium. We adjusted the concentration of sevoflurane to control the MAP and HR within the rang of 20% the basic level. One of six does of ondansetron (0.5mg, 1.0mg,2.0mg,4.0mg,8.0mg,16.0mg) or placebo was gaven during operation. The incidences of PONV, the multiple points required treatments, and the degree of satisfaction were recorded during the 24-hour study periods. and nausea scores via a visual analog scale (VAS) were recorded on a 0 to 10 scale at multiple time points during the 24-hour study period. The rescue antiemetic (droperidol 1.25mg) i.v.was given and the time were recorded, if patient remained nauseous for more than 15 minutes, experience severe nausea, or if requested by the patient during study period. Result:There were no significant difference in the VAS scores between 7 groups. The incidence of PONV was significantly lower in the group (ondansetron 8mg) than in others, especially the group (ondansetron Omg) (x2=7.88, P=0.005). The satisfaction in the group (ondansetron Omg) was lower than in others, especially the group (ondansetron 8mg) (F=1.54, P=0.04). According to Kaplan-Meier analysis of the need for rescue, which suggested the superiority of the group (ondansetron 8mg) to the other groups, especially the group (ondansetron Omg) (x2=1.93, P=0.004). Conclusion:The recomm-ended dose of ondansetron for PONV prophylaxis remains ondansetron 8mg during laparoscopic cholecystectomy in women.