tropisetron and Genital-Diseases--Female

We have studied the incidence of postoperative nausea and vomiting (PONV) and the effect of prophylactic tropisetron, a 5-HT3 antagonist, during the first 24 hr after elective gynecologic laparoscopic surgery. Thirty-two of 68 patients (47%) experienced nausea or vomiting some time during the observation period. Sixteen of these patients (50%) had their first emetic symptoms after discharge from the recovery room. We could see no difference in the frequency of PONV in the patients who were given prophylactic tropisetron 5 mg orally before anesthesia.

Topics: Adolescent; Adult; Antiemetics; Female; Genital Diseases, Female; Humans; Indoles; Laparoscopy; Middle Aged; Postoperative Nausea and Vomiting; Serotonin Antagonists; Treatment Outcome; Tropisetron

This study was performed to compare the efficacy of tropisetron, droperidol, and saline in the prevention of postoperative nausea and vomiting (PONV) and to compare the possible adverse effects of these drugs in gynecologic incontinence surgery. Using a randomized, double-blind study design, we studied 150 women undergoing gynecologic incontinence surgery with standardized general anesthesia. At the end of surgery, the patients received either tropisetron 5 mg, droperidol 1.25 mg, or 0.9% saline intravenously (i.v.). As a rescue antiemetic, the patients received metoclopramide 10 mg i.v.. The episodes of nausea, retching, and vomiting; the need for rescue treatment; and the type and severity of adverse events were recorded at four occasions during the 48-h observation period. Pain, anxiety, drowsiness, and general satisfaction were also evaluated on a linear numerical scale of 0-10. Complete response (no PONV within the 48-h observation period) occurred similarly in the study groups (tropisetron 25%, droperidol 22%, and placebo 18%). Tropisetron and droperidol had no effect on the incidence of nausea and retching. However, the incidence of vomiting was significantly less in the tropisetron group than in the placebo group (tropisetron 19%, droperidol 45%, and placebo 57%). The number of emetic episodes (retching and/or vomiting) per patient within 48 h was significantly decreased under tropisetron when compared with placebo (tropisetron 2.5 +/- 3.4, droperidol 4.2 +/- 6.1, placebo 5.9 +/- 7.1). With regard to adverse events, the patients in the droperidol group had significantly more anxiety than the placebo group (2-6 h postoperatively), more drowsiness than the tropisetron and placebo groups (0-2 h postoperatively), and more dissatisfaction than the tropisetron (0-6 h postoperatively) and placebo groups (2-6 h postoperatively). We conclude that tropisetron given 5 mg i.v. during anesthesia in gynecologic incontinence surgery effectively prevents vomiting but not nausea and retching, while 1.25 mg i.v. droperidol fails to prevent any of these emetic symptoms and results in adverse events.

Topics: Antiemetics; Double-Blind Method; Droperidol; Female; Genital Diseases, Female; Humans; Indoles; Middle Aged; Nausea; Postoperative Complications; Sodium Chloride; Tropisetron; Vomiting

In a double-blind study, we have compared the prophylactic antiemetic effect of tropisetron 5 mg (Navoban, a 5-HT3 receptor antagonist) with that of placebo, both given as a short i.v. infusion approximately 15 min before wound closure in patients undergoing gynaecological surgery. Perioperative anaesthetic care was standardized and patients were observed for at least 24 h after operation. The 35 patients given tropisetron and 34 given placebo treatment were well matched for characteristics. Vomiting occurred in 26% of tropisetron-treated patients, compared with 59% of placebo-treated patients (P = 0.006); 69% of tropisetron-treated patients suffered nausea, compared with 88% of placebo-treated patients (P = 0.05). In addition, patients judged the antiemetic treatment with tropisetron as more effective than the placebo treatment (visual analogue score 71 vs 51 mm (P = 0.003)).

Topics: Adult; Aged; Double-Blind Method; Female; Genital Diseases, Female; Humans; Indoles; Middle Aged; Nausea; Postoperative Complications; Serotonin Antagonists; Tropisetron; Vomiting