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Prophylactic iv ondansetron reduces nausea, vomiting and pruritus following epidural morphine for postoperative pain control

[L’administration prophylactique d’ondansétron iv réduit les nausées, les vomissements et le prurit qui suivent l’administration péridurale de morphine analgésique postopératoire]

Jann-Inn Tzeng, MD^*,, Koung-Shing Chu, MD^*, Shung-Tai Ho, MD MS, Kuang-I Cheng, MD^*, Kuo-Sheng Liu, MS^* and Jhi-Joung Wang, MD DMS^*,

^* From the Departments of Medical Research
and Anesthesiology, Chi-Mei Medical Center, Tainan;
and the Department of Anesthesiology, Tri-Service General Hospital, Taipei, Taiwan.

Address correspondence to: Dr. Jhi-Joung Wang, Professor, Department of Anesthesiology, Chi-Mei Medical Center, No. 901, Chung-Hwa Rd, Yung-Kang City, Tainan, Taiwan. Phone: 886-6-2812811, ext. 2630; Fax: 886-6-2832639; E-mail: 400002{at}mail.chimei.org.tw

Purpose: To evaluate the prophylactic effect of ondansetron on nausea and vomiting following epidural morphine for postoperative pain control.

Methods: Seventy women (n = 35 in each group) undergoing abdominal total hysterectomy under epidural anesthesia were enrolled in this randomized, double-blinded, and placebo-controlled study. At the end of surgery, all patients received epidural morphine 3 mg for postoperative pain relief. Before morphine injection, the ondansetron group received iv ondansetron 4 mg, whereas the placebo group received iv saline.

Results: Patients in the ondansetron group reported a lower frequency of total postoperative nausea and vomiting (22%) and lower frequency of rescue antiemetic request (12%) than those in the placebo group (52% and 39%, respectively; P < 0.05). In addition, ondansetron was associated with a reduced incidence of pruritus following epidural morphine (28% vs 58%; P < 0.05).

Conclusion: We conclude that iv ondansetron 4 mg is effective in the prevention of nausea, vomiting, and pruritus following epidural morphine for postoperative pain control.

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