Purpose Droperidol and the new serotonin -3antagonists are effective drugs for the prophyla xis of postoperative nausea and vomiting(PONV).The aim of this trial was to evaluate whether dolasetron coul d be a substitut...Purpose Droperidol and the new serotonin -3antagonists are effective drugs for the prophyla xis of postoperative nausea and vomiting(PONV).The aim of this trial was to evaluate whether dolasetron coul d be a substitute for droperidol,because the Food and Dru g Administration has required a Black Box warning on th e droperidol package insert.Design Randomized,placebo-controlled,double-blinded trial.Participant s Inpatients undergoing vitreoretinal surgery(standard 3-port pars plana vitrecto-my for proliferative diabetic vitre oretinopathy,complicat-ed retinal detachment,or macular di sease,such as macular pucker,macular hole,or choroidal neovascu-larization).Intervention Two hundred forty patients(3×80)receiving droperidol(10μg·kg -1 ),dolasetron(12.5mg ),or the combination of both drugs adm inis-tered 5to 10minutes before the end of surgery.Control Eighty patients received saline pla cebos as controls.Methods Standardized general anesthesia was performed,including benzodiazepine premedic ation,propofol,a-tracurium or vecuronium,desfluran e in N 2 O /O 2 ,and a continuous infusion of remifentani l.Postoperative anal-gesia and antiemetic rescue medication were standard-ized.Episodes of vomiting,retchin g,nausea,and the need for additional antiemetics were recorded for 24hours.Main outcome measures Severity of PONV(rated by a standardized scoring algorithm)-was analyzed as the main end point of the study using the K ruskal-Wallis test.Results Data of 304patients could be analyzed.Mean severity scores in the placebo,dolasetron,droperidol,and combination groups were 1.21,0.76,0.47,and 0.30.Incidences of PONV of any severity were 56%,40%,28%,and 18%,respectively.The reduction of the incidence of PONV an d its severity was statistically significant in the dr operidol group and in the combination group relative to the pl acebo.Dolasetron alone failed to reduce the incidence of PONV.The combination of dolasetron and droperidol showed an ad-ditive antiemetic efficacy.Conclu sion Low-dose droperi-dol(10μg·kg -1 )but not dolasetron(12.5mg )re-duced postoperative nausea and vomi ting after vitreoreti-nal surgery.Dolasetron(12.5mg )is not an equivalent substitute for droperidol.展开更多
文摘Purpose Droperidol and the new serotonin -3antagonists are effective drugs for the prophyla xis of postoperative nausea and vomiting(PONV).The aim of this trial was to evaluate whether dolasetron coul d be a substitute for droperidol,because the Food and Dru g Administration has required a Black Box warning on th e droperidol package insert.Design Randomized,placebo-controlled,double-blinded trial.Participant s Inpatients undergoing vitreoretinal surgery(standard 3-port pars plana vitrecto-my for proliferative diabetic vitre oretinopathy,complicat-ed retinal detachment,or macular di sease,such as macular pucker,macular hole,or choroidal neovascu-larization).Intervention Two hundred forty patients(3×80)receiving droperidol(10μg·kg -1 ),dolasetron(12.5mg ),or the combination of both drugs adm inis-tered 5to 10minutes before the end of surgery.Control Eighty patients received saline pla cebos as controls.Methods Standardized general anesthesia was performed,including benzodiazepine premedic ation,propofol,a-tracurium or vecuronium,desfluran e in N 2 O /O 2 ,and a continuous infusion of remifentani l.Postoperative anal-gesia and antiemetic rescue medication were standard-ized.Episodes of vomiting,retchin g,nausea,and the need for additional antiemetics were recorded for 24hours.Main outcome measures Severity of PONV(rated by a standardized scoring algorithm)-was analyzed as the main end point of the study using the K ruskal-Wallis test.Results Data of 304patients could be analyzed.Mean severity scores in the placebo,dolasetron,droperidol,and combination groups were 1.21,0.76,0.47,and 0.30.Incidences of PONV of any severity were 56%,40%,28%,and 18%,respectively.The reduction of the incidence of PONV an d its severity was statistically significant in the dr operidol group and in the combination group relative to the pl acebo.Dolasetron alone failed to reduce the incidence of PONV.The combination of dolasetron and droperidol showed an ad-ditive antiemetic efficacy.Conclu sion Low-dose droperi-dol(10μg·kg -1 )but not dolasetron(12.5mg )re-duced postoperative nausea and vomi ting after vitreoreti-nal surgery.Dolasetron(12.5mg )is not an equivalent substitute for droperidol.
