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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE

A Journal on Physiopathology and Surgery of the Foot


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Chirurgia Del Piede 2001 March;25(1):31-40

language: Italian

Postoperative nausea and vomiting (PONV) prevention in foot surgery

Napoli V.


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Background. In order to reduce the incidence of postoperative nausea and vomiting (PONV), unpleasant collateral effects which are difficult to treat, it is useful to associate prophylactic measures (fasting for at least 10-12 hours prior to surgery and anxiety sedation) with the use of antiemetic drugs. Various types of drugs have been proposed over the years, often with uncertain results and a high incidence of collateral effects. A new class of drugs is now being used which acts by blocking serotonin, identified as mediating transmission of the vomiting stimulus, released by anesthesiological and surgical procedures. This study evaluates the efficacy and tolerability of two anti-serotoninergic drugs: Ondansetron and Dolasetron, used to prevent PONV in 200 cases of foot surgery performed under general anesthesia.
Methods. One hundred patients were treated with 4 mg Ondansetron (1 phial) i.v. before the start of surgery. Eighty-seven did not complain of disorders, while 13 were affected by nausea or vomiting.
Results. Of 100 patients treated with Dolasetron, administered as a drip on awakening from anesthesia, 11 presented PONV and 89 did not report any symptoms.
Conclusions. Both drugs were more efficacious than other forms of treatment as means of reducing the incidence of PONV, but were not completely resolutory owing to its multifactorial etiology.

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