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A comparison of ranitidine, droperidol or placebo in the prevention of nausea and vomiting after hysterectomy

Abstract

Purpose

The effect of ranitidine on postoperative nausea and vomiting (PONV) was assessed when compared with droperidol and with placebo.

Methods

Three groups of sixty patients were studied in a double-blind randomized manner. The first group received ranitidine tablets 300 mg on the night before and on the following morning, one hour before induction of anaesthesia. Thirty minutes before surgery ended they were given isotonic saline 0.3 ml iv. The second group had placebo in place of ranitidine while before the operation ended, droperidol 0.75 mg (0.3 ml) was injected. The third group received placebos rather than the study drugs. The immediate two-hour postoperative recovery room period and that on the ward were evaluated until the next morning. PONV information was gathered from complaints by the patients and from direct questioning by the nursing staff. Droperidol 0.75 mg iv served as the “rescue drug”.

Results

Less PONV occurred in patients who received antiemetics vthan those given placebo: recovery room, P = 0.0109; ward, P = 0.007. Droperidol better suppressed PONV in the recovery room (P = 0.005) with no statistical significance seen between ranitidine and placebo. On the ward, both antiemetics were more effective than placebo (ranitidine, P = 0.01; droperidol, P = 0.003). “Rescue drug” requirements throughout the study periods were not statistically significant.

Conclusion

Although both anti-emetics were associated with a smaller incidence of PONV than was placebo, droperidol was superior to ranitidine in preventing sickness during the immediate postoperative period. The need for the “rescue drug” was similar in all groups.

Résumé

Objectif

Comparer l’effet de la ranitidine sur les nausées et vomissements postopératoires à celui du dropéridol et d’un placebo.

Méthodes

Cette étude randomisée et en double aveugle portait sur trois groupes de 60 patients. Le premier groupe a reçu de la ranitidine en tablette 300 mg la veille et le matin de l’intervention, une heure avant l’induction de l’anesthésie. Trente minutes avant la fin de l’intervention, ses membres ont reçu 0,3 ml iv de sol. physiologique isotonique. Le deuxième groupe a reçu un placebo au lieu de la ranitidine et avant la fin de l’intervention, du dropéridol 0,75 mg (0,3 ml) iv. Le troisième groupe n ’a reçu que du placebo. L’évaluation a été effectuée à la salle de réveil pendant les deux heures qui ont suivi l’intervention et, dans le service, jusqu ’au lendemain matin. Les renseignement sur les nausées et vomissements provenaient des plaintes spontanées et des questions du personnel infirmier. Le médicament de sauvetage était dropéridol 0,75 mg iv.

Résultats

Les nausées et vomissements ont été moins fréquents chez les patients qui avaient reçu des antiémétiques plutôt qu’un placebo: à la salle de réveil, P = 0,0109; dans le service, P = 0,007. Le dropéridol protège mieux des nausées et des vomissements en salle de réveil (P = 0,005) et il n’y pas eu de différence entre la ranitidine et le placebo. Dans le service, les deux antiémétiques ont été plus efficaces que le placebo (ranitidine, P = 0,01; dropéridol, P = 0.003). Les besoins en médicament de sauvetage n ’ont pas différé.

Conclusion

Bien que les deux antiémétiques aient été associés à une incidence plus faible de nausées et vomissements, le dropéridol a été supérieur à la ranitidine pendant la période postopératoire immédiate. Les besoins en médicaments de sauvetage ont été les mêmes dans tous les groupes.

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Correspondence to Dimitri Cozanitis.

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Cozanitis, D., Asantila, R., Eklund, P. et al. A comparison of ranitidine, droperidol or placebo in the prevention of nausea and vomiting after hysterectomy. Can J Anaesth 43, 106 (1996). https://doi.org/10.1007/BF03011249

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Key words

  • anaesthesia: gynaecological
  • pharmacology: droperidol, ranitidine
  • vomiting: anti-emetics, incidence, postoperative