Top

BMC Anesthesiology

Published in:

Open Access 01-12-2020 | Nausea | Research article

Oral mosapride can provide additional anti-emetic efficacy following total joint arthroplasty under general anesthesia: a randomized, double-blinded clinical trial

Authors: Jinwei Xie, Yingchun Cai, Jun Ma, Qiang Huang, Fuxing Pei

Published in: BMC Anesthesiology | Issue 1/2020

Abstract

Background

We sought to determine (1) whether the addition of prophylactic oral mosapride to a protocol including dexamethasone and ondansetron further reduces postoperative nausea and vomiting (PONV) compared with ondansetron alone or the combination of both; (2) whether preemptive application of oral mosapride provides additional clinical benefits for bowel function and appetite, thus improving functional recovery.

Methods

We randomized 240 patients undergoing total hip and knee arthroplasty to receive placebo (Control, n = 80), dexamethasone (10 mg) before anesthesia induction (Dexa, n = 82), or dexamethasone (10 mg) before anesthesia induction as well as oral mosapride (5 mg) before and after surgery (Mosa+Dexa, n = 78). Patients were assessed at 0–6, 6–12, 12–24, and 24–48 h postoperatively. Primary outcomes were incidence and severity of PONV as well as complete response. Secondary outcomes were appetite, time until first defecation and ambulation, patient satisfaction score, and length of hospital stay.

Results

Mosa+Dexa patients showed significantly lower incidence of nausea at 6–12 h (3.8%) and over the entire evaluation period (6.4%), as well as a higher rate of complete response (89.7%) than other patients. Mosa+Dexa patients required less time to achieve first defecation and ambulation, they were hospitalized for shorter time, and they were more satisfied with clinical care.

Conclusion

Addition of oral mosapride further reduced incidence of PONV, especially postoperative nausea, during 6–12 h postoperatively. Moreover, preemptive application of oral mosapride can further improve appetite, bowel function, ambulation and length of hospital stay.

Trial registration

The study protocol was registered at the Chinese Clinical Trial Registry (ChiCTR1800015896), prospectively registered on 27/04/2018.

Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89(4):780–5. https://doi.org/10.2106/JBJS.F.00222.CrossRefPubMed

Patel A, Pavlou G, Mujica-Mota RE, Toms AD. The epidemiology of revision total knee and hip arthroplasty in England and Wales: a comparative analysis with projections for the United States. A study using the National Joint Registry dataset. Bone Joint J. 2015;97-B(8):1076–81. https://doi.org/10.1302/0301-620X.97B8.35170.CrossRefPubMed

Lin CJ, Williams BA. Postoperative nausea and vomiting in ambulatory regional anesthesia. Int Anesthesiol Clin. 2011;49(4):134–43. https://doi.org/10.1097/AIA.0b013e318216bf9c.CrossRefPubMed

Sansonnens J, Taffe P, Burnand B, group ADSs. Higher occurrence of nausea and vomiting after total hip arthroplasty using general versus spinal anesthesia: an observational study. BMC Anesthesiol. 2016;16(1):44. https://doi.org/10.1186/s12871-016-0207-0.CrossRefPubMedPubMedCentral

Sculco PK, Pagnano MW. Perioperative solutions for rapid recovery joint arthroplasty: get ahead and stay ahead. J Arthroplast. 2015;30(4):518–20. https://doi.org/10.1016/j.arth.2015.01.036.CrossRef

Kehlet H. Fast-track hip and knee arthroplasty. Lancet. 2013;381(9878):1600–2. https://doi.org/10.1016/S0140-6736(13)61003-X.CrossRefPubMed

Gan TJ, Diemunsch P, Habib AS, Kovac A, Kranke P, Meyer TA, Watcha M, Chung F, Angus S, Apfel CC, Bergese SD, Candiotti KA, Chan MT, Davis PJ, Hooper VD, Lagoo-Deenadayalan S, Myles P, Nezat G, Philip BK, Tramer MR, Society for Ambulatory A. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2014;118(1):85–113. https://doi.org/10.1213/ANE.0000000000000002.CrossRefPubMed

Kranke P, Diemunsch P. The 2014 consensus guidelines for the management of postoperative nausea and vomiting: a leapfrog towards a postoperative nausea and vomiting-free hospital. Eur J Anaesthesiol. 2014;31(12):651–3. https://doi.org/10.1097/EJA.0000000000000080.CrossRefPubMed

Eberhart LH, Kranke P. Postoperative nausea and vomiting: is everything now solved or still more questions than answers? Eur J Anaesthesiol. 2016;33(12):878–80. https://doi.org/10.1097/EJA.0000000000000527.CrossRefPubMed

10.

Ross-Adjie GM, Monterosso L, Bulsara M. Bowel management post major joint arthroplasty: results from a randomised controlled trial. Int J Orthop Trauma Nurs. 2015;19(2):92–101. https://doi.org/10.1016/j.ijotn.2014.04.002.CrossRefPubMed

11.

Xu B, Ma J, Huang Q, Huang ZY, Zhang SY, Pei FX. Two doses of low-dose perioperative dexamethasone improve the clinical outcome after total knee arthroplasty: a randomized controlled study. Knee Surg Sports Traumatol Arthrosc. 2018;26(5):1549–56. https://doi.org/10.1007/s00167-017-4506-x.CrossRefPubMed

12.

Lei YT, Xu B, Xie XW, Xie JW, Huang Q, Pei FX. The efficacy and safety of two low-dose peri-operative dexamethasone on pain and recovery following total hip arthroplasty: a randomized controlled trial. Int Orthop. 2018;42(3):499–505. https://doi.org/10.1007/s00264-017-3537-8.CrossRefPubMed

13.

Dorn S, Lembo A, Cremonini F. Opioid-induced bowel dysfunction: epidemiology, pathophysiology, diagnosis, and initial therapeutic approach. Am J Gastroenterol Suppl. 2014;2(1):31–7. https://doi.org/10.1038/ajgsup.2014.7.CrossRefPubMed

14.

Mine Y, Oku S, Yoshida N. Anti-emetic effect of mosapride citrate hydrate, a 5-HT4 receptor agonist, on selective serotonin reuptake inhibitors (SSRIs)-induced emesis in experimental animals. J Pharmacol Sci. 2013;121(1):58–66. https://doi.org/10.1254/jphs.12175fp.CrossRefPubMed

15.

Ganesan P, Sharma A, Mohanti BK, Gogia A. Protracted cisplatin-induced vomiting responding to mosapride. Indian J Cancer. 2010;47(1):73–4. https://doi.org/10.4103/0019-509X.58866.CrossRefPubMed

16.

Watcha MF, White PF. Postoperative nausea and vomiting. Its etiology, treatment, and prevention. Anesthesiology. 1992;77(1):162–84. https://doi.org/10.1097/00000542-199207000-00023.CrossRefPubMed

17.

Xiang Y, Ye W, Sun N, Jin X. Analgesic and sedative effects of Dezocine and midazolam during Vitrectomy. Curr Eye Res. 2016;41(11):1460–4. https://doi.org/10.3109/02713683.2015.1128551.CrossRefPubMed

18.

Reibaldi M, Fallico M, Longo A, Avitabile T, Astuto M, Murabito P, Minardi C, Bonfiglio V, Boscia F, Furino C, Rejdak R, Nowomiejska K, Toro M, Cennamo G, Cillino S, Rinaldi M, Fiore T, Cagini C, Russo A. Efficacy of three different prophylactic treatments for postoperative nausea and vomiting after Vitrectomy: a randomized clinical trial. J Clin Med. 2019;8(3). https://doi.org/10.3390/jcm8030391.

19.

Gan TJ, Meyer T, Apfel CC, Chung F, Davis PJ, Eubanks S, Kovac A, Philip BK, Sessler DI, Temo J, Tramer MR, Watcha M, Department of Anesthesiology DUMC. Consensus guidelines for managing postoperative nausea and vomiting. Anesth Analg. 2003;97(1):62–71, table of contents. https://doi.org/10.1213/01.ane.0000068580.00245.95.CrossRefPubMed

20.

Habib AS, Gan TJ. Postoperative nausea and vomiting: then & now. Anesth Analg. 2012;115(3):493–5. https://doi.org/10.1213/ANE.0b013e318254285e.CrossRefPubMed

21.

Sinclair DR, Chung F, Mezei G. Can postoperative nausea and vomiting be predicted? Anesthesiology. 1999;91(1):109–18. https://doi.org/10.1097/00000542-199907000-00018.CrossRefPubMed

22.

Spies CM, Strehl C, van der Goes MC, Bijlsma JW, Buttgereit F. Glucocorticoids. Best Pract Res Clin Rheumatol. 2011;25(6):891–900. https://doi.org/10.1016/j.berh.2011.11.002.CrossRefPubMed

23.

Coutinho AE, Chapman KE. The anti-inflammatory and immunosuppressive effects of glucocorticoids, recent developments and mechanistic insights. Mol Cell Endocrinol. 2011;335(1):2–13. https://doi.org/10.1016/j.mce.2010.04.005.CrossRefPubMedPubMedCentral

24.

D'Souza N, Swami M, Bhagwat S. Comparative study of dexamethasone and ondansetron for prophylaxis of postoperative nausea and vomiting in laparoscopic gynecologic surgery. Int J Gynaecol Obstet. 2011;113(2):124–7. https://doi.org/10.1016/j.ijgo.2010.11.022.CrossRefPubMed

25.

Lunn TH, Kehlet H. Perioperative glucocorticoids in hip and knee surgery - benefit vs. harm? A review of randomized clinical trials. Acta Anaesthesiol Scand. 2013;57(7):823–34. https://doi.org/10.1111/aas.12115.CrossRefPubMed

26.

Kardash KJ, Sarrazin F, Tessler MJ, Velly AM. Single-dose dexamethasone reduces dynamic pain after total hip arthroplasty. Anesth Analg. 2008;106(4):1253–7, table of contents. https://doi.org/10.1213/ANE.0b013e318164f319.CrossRefPubMed

27.

Koh IJ, Chang CB, Lee JH, Jeon YT, Kim TK. Preemptive low-dose dexamethasone reduces postoperative emesis and pain after TKA: a randomized controlled study. Clin Orthop Relat Res. 2013;471(9):3010–20. https://doi.org/10.1007/s11999-013-3032-5.CrossRefPubMedPubMedCentral

28.

Lei Y, Huang Q, Xu B, Zhang S, Cao G, Pei F. Multiple low-dose dexamethasone further improves clinical outcomes following Total hip Arthroplasty. J Arthroplast. 2018;33(5):1426–31. https://doi.org/10.1016/j.arth.2017.11.057.CrossRef

29.

Ho J, Kuhn RJ, Smith KM. Update on treatment options for constipation. Orthopedics. 2008;31(6):570–4. https://doi.org/10.3928/01477447-20080601-12.CrossRefPubMed

30.

Bergeron R, Blier P. Cisapride for the treatment of nausea produced by selective serotonin reuptake inhibitors. Am J Psychiatry. 1994;151(7):1084–6. https://doi.org/10.1176/ajp.151.7.1084.

31.

Richardson AB, Bala A, Wellman SS, Attarian DE, Bolognesi MP, Grant SA. Perioperative dexamethasone administration does not increase the incidence of postoperative infection in Total hip and knee Arthroplasty: a retrospective analysis. J Arthroplast. 2016;31(8):1784–7. https://doi.org/10.1016/j.arth.2016.01.028.CrossRef

32.

Gan TJ. Risk factors for postoperative nausea and vomiting. Anesth Analg. 2006;102(6):1884–98. https://doi.org/10.1213/01.ANE.0000219597.16143.4D.CrossRefPubMed

Title: Oral mosapride can provide additional anti-emetic efficacy following total joint arthroplasty under general anesthesia: a randomized, double-blinded clinical trial
Authors: Jinwei Xie
Yingchun Cai
Jun Ma
Qiang Huang
Fuxing Pei
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Nausea
Postoperative Nausea and Vomiting
General Anesthesia
Dexamethasone
Published in: BMC Anesthesiology / Issue 1/2020
Electronic ISSN: 1471-2253
DOI: https://doi.org/10.1186/s12871-020-01214-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Oral mosapride can provide additional anti-emetic efficacy following total joint arthroplasty under general anesthesia: a randomized, double-blinded clinical trial

Abstract

Background

Methods

Results

Conclusion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Trial registration

Please log in to get access to this content

Other articles of this Issue 1/2020

Retrospective analysis of cases of intraoperative awareness in a large multi-hospital health system reported in the early postoperative period

Systematic comparison of four point-of-care methods versus the reference laboratory measurement of hemoglobin in the surgical ICU setting: a cross-sectional method comparison study

Adding dexmedetomidine to morphine-based analgesia reduces early postoperative nausea in patients undergoing gynecological laparoscopic surgery: a randomized controlled trial

The correlation of intraoperative hypotension and postoperative cognitive impairment: a meta-analysis of randomized controlled trials

Cardiac surgical outcome prediction by blood pressure variability indices Poincaré plot and coefficient of variation: a retrospective study

Predictors of 1-year mortality in patients on prolonged mechanical ventilation after surgery in intensive care unit: a multicenter, retrospective cohort study