Efficacy of Three Different Prophylactic Treatments for Postoperative Nausea and Vomiting after Vitrectomy: A Randomized Clinical Trial

Journal of Clinical Medicine

Paolo Murabito¹  Marinella Astuto¹  Carmelo Minardi¹  Salvatore Cillino²  Katarzyna Nowomiejska³  Robert Rejdak³  Michele Rinaldi⁴  Claudio Furino⁵  Andrea Russo⁶  Michele Reibaldi⁶  Matteo Fallico⁶  Teresio Avitabile⁶  Antonio Longo⁶  Vincenza Bonfiglio⁶  Mario Toro⁶  Francesco Boscia⁷  Gilda Cennamo⁸  Tito Fiore⁹  Carlo Cagini⁹ 

[1] Department of Anaesthesiology, University of Catania, 95123 Catania, Italy;Department of Experimental Biomedicine and Clinical Neuroscience, Ophthalmology Section, University of Palermo, 90127 Palermo, Italy;Department of General Ophthalmology, Medical University of Lublin, 20079 Lublin, Poland;Department of Ophthalmology, Second University of Naples, 80131 Naples, Italy;Department of Ophthalmology, University of Bari, 70124 Bari, Italy;Department of Ophthalmology, University of Catania, 95123 Catania, Italy;Department of Ophthalmology, University of Sassari, 07100 Sassari, Italy;Department of Public Health, University of Naples Federico II, 80131 Naples, Italy;Division of Ophthalmology, Department of Surgery and Biomedical Science, University of Perugia, S Maria della Misericordia Hospital, 06129 Perugia, Italy;

关键词: dexamethasone;    ondansetron;    postoperative nausea and vomiting;    vitrectomy;   

DOI  :  10.3390/jcm8030391

来源: DOAJ

【 摘 要 】

Postoperative nausea and vomiting (PONV) after vitreoretinal surgery may potentially be associated with severe complications, such as suprachoroidal hemorrhage. The purpose of the present multicenter clinical trial (NCT02386059) was to assess the efficacy of three different prophylactic treatments for PONV after vitrectomy under local anesthesia. Patients undergoing primary vitrectomy were randomized to the control arm or to one of the treatment arms (4 mg ondansetron, 4 mg dexamethasone, combination of the two drugs). The primary outcome measure was the proportion of complete response (no nausea, no vomiting, no retching, and no use of antiemetic rescue medication) during 24 h after vitrectomy. Secondary outcomes included the severity standardized score of PONV, postoperative pain standardized score, and rate of ocular and non-ocular adverse events. Baseline demographics of the 1287 patients were comparable between the four arms. The combined therapy group showed a statistically significant lower incidence of PONV compared to the placebo and monotherapy (p < 0.001). PONV severity was also reduced in the combination group compared to the others (p < 0.001). Postoperative pain scores and adverse events were comparable among the four groups. Combined therapy with dexamethasone and ondansetron was the most effective treatment for reducing the incidence and severity of PONV in patients undergoing vitrectomy under local anesthesia.

【 授权许可】

Unknown