Antiemetic Prophylaxis with Ondansetron for Post-discharge Nausea and Vomiting after Hip Arthroscopy Performed under Neuraxial Anesthesia: A Prospective, Randomized, Placebo-controlled Trial

David H Kim, Jacques T YaDeau,

Abstract

Background: Post-Discharge Nausea and Vomiting (PDNV) remain common complaints after ambulatory surgery. This study investigated whether continuation of an anti-emetic regimen for two days postoperatively would reduce PDNV. Methods: A prospective, randomized placebo-controlled trial of 76 patients undergoing ambulatory hip arthroscopy was initiated. All patients received a spinal or combined spinal epidural and intravenous sedation. No intraoperative opioids were given. Prophylatic anti-emetics (dexamethasone, ondansetron) were given. Postoperatively, two groups either received oral placebo or ondansetron for two days. Results: On postdischarge day 1, nausea occurred in 54% of the placebo group and 46% of the oral ondansetron group (p=0.49). On postdischarge day 2 and 3, nausea occurred in 16% and 11% of the placebo group; 18% and 10% of the oral ondansetron group (p=0.84 and p=0.94), respectively. Conclusion: Postdischarge prophylactic oral ondansetron, administered for two days, did not reduce the incidence or severity of nausea in ambulatory hip arthroscopy patients.

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