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A randomized, double-blind comparison of ondansetron versus placebo for prevention of nausea and vomiting after infratentorial craniotomy.

Publication ,  Journal Article
Fabling, JM; Gan, TJ; El-Moalem, HE; Warner, DS; Borel, CO
Published in: J Neurosurg Anesthesiol
April 2002

Ondansetron was compared with placebo for nausea and vomiting prophylaxis after fentanyl/isoflurane/relaxant anesthesia and infratentorial craniotomy. Eight milligrams intravenous ondansetron or vehicle was administered at skin closure. Nausea, emesis, and antiemetic use were recorded at 0, 0.5, 1, 4, 8, 12, 24, and 48 hours. There were no significant intergroup differences for nausea incidence at any interval, but cumulatively the placebo group was 3.2 times more likely to develop nausea during the first 12 hours (P = .04). Nausea incidence was bimodal in both groups, peaking during the first 1 to 4 hours. A nadir occurred at 8 to 12 hours, but nausea increased during the next 36 hours. By 48 hours, approximately 40% of patients in both groups were still nauseated. Reduced vomiting frequency was seen with ondansetron at 4, 8, 12, and 24 hours (P < .05). Despite rescue antiemetics, emesis occurred in an irregular pattern with episodes still observed in 35% of placebo patients at 48 hours. For ondansetron, emesis was infrequent for the first 12 hours but then a persistent increase was observed (48 hours, 22%). The incidence of rescue antiemetic use was 65% for both groups. There was no effect of gender. Nausea and vomiting are frequent and protracted after infratentorial craniotomy. Administration of single-dose ondansetron (8 mg intravenously) at wound closure was partially effective in reducing acute nausea and vomiting but had little delayed benefit. Scheduled prophylactic administration of antiemetic therapy during the first 48 hours after infratentorial craniotomy should be evaluated for efficacy and safety.

Duke Scholars

Published In

J Neurosurg Anesthesiol

DOI

ISSN

0898-4921

Publication Date

April 2002

Volume

14

Issue

2

Start / End Page

102 / 107

Location

United States

Related Subject Headings

  • Prospective Studies
  • Postoperative Nausea and Vomiting
  • Ondansetron
  • Middle Aged
  • Male
  • Injections, Intravenous
  • Infratentorial Neoplasms
  • Humans
  • Female
  • Double-Blind Method
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Fabling, J. M., Gan, T. J., El-Moalem, H. E., Warner, D. S., & Borel, C. O. (2002). A randomized, double-blind comparison of ondansetron versus placebo for prevention of nausea and vomiting after infratentorial craniotomy. J Neurosurg Anesthesiol, 14(2), 102–107. https://doi.org/10.1097/00008506-200204000-00003
Fabling, Jennifer M., Tong J. Gan, Habib E. El-Moalem, David S. Warner, and Cecil O. Borel. “A randomized, double-blind comparison of ondansetron versus placebo for prevention of nausea and vomiting after infratentorial craniotomy.J Neurosurg Anesthesiol 14, no. 2 (April 2002): 102–7. https://doi.org/10.1097/00008506-200204000-00003.
Fabling JM, Gan TJ, El-Moalem HE, Warner DS, Borel CO. A randomized, double-blind comparison of ondansetron versus placebo for prevention of nausea and vomiting after infratentorial craniotomy. J Neurosurg Anesthesiol. 2002 Apr;14(2):102–7.
Fabling, Jennifer M., et al. “A randomized, double-blind comparison of ondansetron versus placebo for prevention of nausea and vomiting after infratentorial craniotomy.J Neurosurg Anesthesiol, vol. 14, no. 2, Apr. 2002, pp. 102–07. Pubmed, doi:10.1097/00008506-200204000-00003.
Fabling JM, Gan TJ, El-Moalem HE, Warner DS, Borel CO. A randomized, double-blind comparison of ondansetron versus placebo for prevention of nausea and vomiting after infratentorial craniotomy. J Neurosurg Anesthesiol. 2002 Apr;14(2):102–107.

Published In

J Neurosurg Anesthesiol

DOI

ISSN

0898-4921

Publication Date

April 2002

Volume

14

Issue

2

Start / End Page

102 / 107

Location

United States

Related Subject Headings

  • Prospective Studies
  • Postoperative Nausea and Vomiting
  • Ondansetron
  • Middle Aged
  • Male
  • Injections, Intravenous
  • Infratentorial Neoplasms
  • Humans
  • Female
  • Double-Blind Method