Affiliation:
1. Postgraduate Program of Anesthesiology, Surgical Sciences and Perioperative Medicine Faculdade de Medicina da Universidade de São Paulo (USP) São Paulo Brazil
2. Department of Anesthesiology, Pain Center University of Groningen, University Medical Center Groningen Groningen The Netherlands
3. Faculdade de Medicina da Universidade de São Paulo (USP) São Paulo Brazil
Abstract
SummaryPostoperative nausea or vomiting occurs in up to 40% in patients with multiple risk factors, despite prophylaxis. Olanzapine is an antipsychotic drug that is used to prevent nausea and vomiting in palliative care and to treat chemotherapy‐induced nausea and vomiting. This study aimed to examine whether pre‐operative olanzapine, as a prophylactic anti‐emetic added to intra‐operative dexamethasone, ondansetron and total intravenous anaesthesia, reduced the incidence of postoperative nausea or vomiting. We performed a multiply‐blinded randomised controlled trial in patients aged 18–60 years with cancer at high risk of postoperative nausea or vomiting (three or four risk factors according to the Apfel criteria) plus a previous history of chemotherapy‐induced nausea and vomiting. Patients were allocated at random to receive 10 mg olanzapine or placebo orally 1 h before surgery in addition to a two‐drug regimen (dexamethasone and ondansetron) and propofol anaesthesia to prevent postoperative nausea or vomiting. The primary outcome was the incidence of postoperative nausea or vomiting in the first 24 h after surgery. In total, 100 patients were enrolled; 47 in the olanzapine group and 49 in the control group completed the study. The baseline characteristics of the groups were similar. The incidence of postoperative nausea or vomiting in the first 24 h after surgery was lower in the olanzapine group (12/47, 26%) than in the control group (31/49, 63%) (p = 0.008, RR 0.40 (95%CI 0.21–0.79)). Adding pre‐operative oral olanzapine to intra‐operative dexamethasone and ondansetron was highly effective in reducing the risk of postoperative nausea or vomiting in the first 24 hours after surgery in patients with a previous history of chemotherapy‐induced nausea and vomiting and at least three Apfel risk factors for postoperative nausea or vomiting.
Subject
Anesthesiology and Pain Medicine
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献