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Journal of Anesthesia

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18-12-2023 | Postoperative Nausea and Vomiting | Original Article

Associations between ondansetron and the incidence of postoperative nausea and vomiting and food intake in Japanese female undergoing laparoscopic gynecological surgery: a retrospective study

Authors: Kazuhiro Shirozu, Kaoru Umehara, Shinnosuke Takamori, Sayuri Takase, Ken Yamaura

Published in: Journal of Anesthesia | Issue 2/2024

Abstract

Purpose

Prevention of postoperative nausea and vomiting (PONV) is important to achieve DREAM (drinking, eating, mobilization). Ondansetron inhibits PONV, but its effects on postoperative food intake have not been investigated. This study aimed to examine associations between ondansetron and PONV incidence, and postoperative food intake.

Methods

This retrospective study included adult patients (n = 632) who underwent laparoscopic gynecological surgery at Kyushu University Hospital between January 2017 and June 2023. Outcomes were PONV on the day of surgery, PONV up to the day after surgery, and food intake, which was assessed for breakfast and lunch on the day after surgery. Odds ratios (ORs) for PONV incidence and postoperative no-food intake were calculated between those with and without ondansetron during surgery. Multivariable-adjusted analysis was performed using possible confounding factors for PONV. Synergistic effects of combining ondansetron with dexamethasone or total intravenous anesthesia (TIVA) were assessed.

Results

Multivariable-adjusted ORs for PONV on the day of surgery and up to the day after surgery were 0.56 (95% confidence interval, 0.32–0.99, p = 0.04) and 0.52 (0.30–0.93, p = 0.03), respectively, in the ondansetron group (n = 84) compared with the non-ondansetron group (n = 548). In contrast, multivariable-adjusted ORs for no-food intake of breakfast and lunch the day after surgery in the ondansetron group compared with the non-ondansetron group were not significant. Analysis of synergistic effects on PONV showed no significant interaction between ondansetron and dexamethasone or ondansetron and TIVA combinations.

Conclusion

Ondansetron administration during surgery was significantly associated with decreased PONV risk but was not associated with food intake the day after surgery.

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Gustafsson UO, Scott MJ, Schwenk W, Demartines N, Roulin D, Francis N, McNaught CE, MacFie J, Liberman AS, Soop M, Hill A, Kennedy RH, Lobo DN, Fearon K, Ljungqvist O, Enhanced Recovery After Surgery S. Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS(R)) Society recommendations. Clin Nutr. 2012;31(6):783–800.CrossRefPubMed

Oliver CM, Warnakulasuriya S, McGuckin D, Singleton G, Martin P, Santos C, Bedford J, Wagstaff D, Sahni A, Gilhooly D, Wilson J, Edwards K, Baumber R, Vindrola-Padros C, Dorey J, Leeman I, Boyd-Carson H, Vohra R, Singh P, Bedford M, Vallance A, Aresu G, Tucker O, Swart M, Mythen MG, Team Ppd, Moonesinghe SR, Collaborative P. Delivery of drinking, eating and mobilising (DrEaMing) and its association with length of hospital stay after major noncardiac surgery: observational cohort study. Br J Anaesth. 2022;129(1):114–26.CrossRefPubMedPubMedCentral

Gan TJ, Belani KG, Bergese S, Chung F, Diemunsch P, Habib AS, Jin Z, Kovac AL, Meyer TA, Urman RD, Apfel CC, Ayad S, Beagley L, Candiotti K, Englesakis M, Hedrick TL, Kranke P, Lee S, Lipman D, Minkowitz HS, Morton J, Philip BK. Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting. Anesth Analg. 2020;131(2):411–48.CrossRefPubMed

Kovac AL. Comparative Pharmacology and Guide to the Use of the Serotonin 5-HT(3) Receptor Antagonists for Postoperative Nausea and Vomiting. Drugs. 2016;76(18):1719–35.CrossRefPubMed

Lee DC, Vetter TR, Dobyns JB, Crump SJ, Benz DL, Short RT, Parks DA, Beasley TM, Liwo AN. Sociodemographic Disparities in Postoperative Nausea and Vomiting. Anesth Analg. 2023;137(3):665–75.CrossRefPubMed

Tang J, Wang B, White PF, Watcha MF, Qi J, Wender RH. The effect of timing of ondansetron administration on its efficacy, cost-effectiveness, and cost-benefit as a prophylactic antiemetic in the ambulatory setting. Anesth Analg. 1998;86(2):274–82.CrossRefPubMed

Kakuta N, Kume K, Hamaguchi E, Tsutsumi R, Mita N, Tanaka K, Tsutsumi YM. The effects of intravenous fosaprepitant and ondansetron in the prevention of postoperative nausea and vomiting in patients who underwent lower limb surgery: a prospective, randomized, double-blind study. J Anesth. 2015;29(6):836–41.CrossRefPubMed

Matsota P, Angelidi M, Pandazi A, Tzirogiannis KN, Panoutsopoulos GI, Kostopanagiotou G. Ondansetron-droperidol combination vs. ondansetron or droperidol monotherapy in the prevention of postoperative nausea and vomiting. Arch Med Sci. 2015;11(2):362–70.CrossRefPubMedPubMedCentral

Sanchez-Ledesma MJ, Lopez-Olaondo L, Pueyo FJ, Carrascosa F, Ortega A. A comparison of three antiemetic combinations for the prevention of postoperative nausea and vomiting. Anesth Analg. 2002;95(6):1590–5 (Table of contents).CrossRefPubMed

10.

Habib AS, White WD, Eubanks S, Pappas TN, Gan TJ. A randomized comparison of a multimodal management strategy versus combination antiemetics for the prevention of postoperative nausea and vomiting. Anesth Analg. 2004;99(1):77–81.CrossRefPubMed

11.

Ashforth EI, Palmer JL, Bye A, Bedding A. The pharmacokinetics of ondansetron after intravenous injection in healthy volunteers phenotyped as poor or extensive metabolisers of debrisoquine. Br J Clin Pharmacol. 1994;37(4):389–91.CrossRefPubMedPubMedCentral

12.

Myrand SP, Sekiguchi K, Man MZ, Lin X, Tzeng RY, Teng CH, Hee B, Garrett M, Kikkawa H, Lin CY, Eddy SM, Dostalik J, Mount J, Azuma J, Fujio Y, Jang IJ, Shin SG, Bleavins MR, Williams JA, Paulauskis JD, Wilner KD. Pharmacokinetics/genotype associations for major cytochrome P450 enzymes in native and first- and third-generation Japanese populations: comparison with Korean, Chinese, and Caucasian populations. Clin Pharmacol Ther. 2008;84(3):347–61.CrossRefPubMed

Title: Associations between ondansetron and the incidence of postoperative nausea and vomiting and food intake in Japanese female undergoing laparoscopic gynecological surgery: a retrospective study
Authors: Kazuhiro Shirozu
Kaoru Umehara
Shinnosuke Takamori
Sayuri Takase
Ken Yamaura
Publication date: 18-12-2023
Publisher: Springer Nature Singapore
Keywords: Postoperative Nausea and Vomiting
Dexamethasone
Operative Gynecology
Operative Gynecology
Fentanyl
Published in: Journal of Anesthesia / Issue 2/2024
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI: https://doi.org/10.1007/s00540-023-03295-0

Keynote webinar | Spotlight on medication adherence

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Associations between ondansetron and the incidence of postoperative nausea and vomiting and food intake in Japanese female undergoing laparoscopic gynecological surgery: a retrospective study

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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