Characterization of the Use of Antiemetics in the Postoperative Period in Adult Patients Undergoing Surgery during January to May 2009 in a private hospital, Clínica Bíblica, in Costa Rica

Autores/as

  • Natalia Apuy Roldàn Universidad de Costa Rica
  • Jose Miguel Chaverri Fernàndez Universidad de Costa Rica
  • Mónica Monge Aguilera Universidad de Costa Rica
  • Esteban Zavaleta Monestel Hospital Clinica Biblica

DOI:

https://doi.org/10.51481/amc.v52i3.745

Palabras clave:

nausea, vomiting, postoperative, anesthetics, antiemetics, postoperative nausea and vomiting

Resumen

Versión traducida del artículo "Caracterización del uso de antieméticos en el postoperatorio en pacientes adultos sometidos a cirugía durante el periodo enero-mayo 2009, en el Hospital Clínica Bíblica de Costa Rica" DOI: https://doi.org/10.51481/amc.v52i3.662

 

Aim: To evaluate and characterize the pharmacotherapeutic approach with antiemetics during the postoperative, in adult patients undergoing surgery at the Hospital Clínica Bíblica (a private hospital in Costa Rica).

 

Methods: Patients (with ages between 18 and 75), who underwent surgery and received some kind of prophylactic antiemetic before the procedure, were selected. Patients that had hospitalization periods shorter than 24 hours were excluded.

 

Results: Prophylactic antiemetic therapy utilized in this hospital includes: granisetron, metoclopramide, dexamethasone, and dimenhydrinate. Granisetron, either alone or combined, was the most used antiemetic in 81% of the cases. The most commonly used combination was dexamethasone and granisetron in 57% of the cases. Without considering the surgical procedure, the incidence of postoperative nausea and vomiting (PONV) was 12% in patients taking granisetron, 25% with metoclopramide, 9% with dimenhydrinate, 13% with dexamethasone and 14% with other antiemetics. The surgeries with the greater incidence of PONV were orthopaedic surgery, 30%, and laparoscopic surgery, 28%. Finally, in cases in which fentanyl was used as an anesthetic, 18% of the patients presented PONV, whereas in patients cases were fentanyl was not used, the rate was 9%.

 

Conclusion: Despite the widespread use of prophylactic antiemetics, PONV still occurs in patients at this private hospital. In spite of the wealth of knowledge in this field, physicians have not yet found an algorithm capable of the total prevention of PONV. Each patient’s individual risk and satisfaction should be taken into account. Further research on this matter must continue in order to unify and improve criteria for PONV treatment.

 

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Citas

González E, Delgado M. Estudio comparativo de la eficacia entre difenidol, ondansetrón y metoclopramida para la prevención y tratamiento de la náusea y el vómito postoperatorios en pacientes sometidos a intervención quirúrgica de oído y mastoides. Rev Esp Med Quir 2008; 13:153-8.

Bel I, Gambús P. Estratificación del riesgo, profilaxis y tratamiento de las náuseas y vómitos postoperatorios. Rev Esp Anestesiol 2006; 53: 301-311.

Ho K, Chiu J. Multimodal antiemetic therapy and emetic risk profiling. Ann Acad Med Singapore 2005; 34:196-205.

Kushwaha B, Chakraborty A, Agarwal J, Malick A, Bhushan S, Bhattacharya P. Comparative study of granisetron and ondansetron alone and their combination with dexamethasone, for prevention of PONV in middle ear surgery. Internet Journal of Anesthesiology 2007; 13:2.

Wattwil M, Thorn S, Lovqvist A. Dexamethasone is as effective as ondasetron for the prevention of postoperative nausea and vomiting following breast surgery. Acta Anaesthesiol Scand 2003; 47:823-827.

Montejo K, González I, Perdomo J, González E, Domech A. Prevención de las náuseas y vómitos postoperatorios. Rev méd electrón [Seriada en línea] 2007 [10 de enero 2009], 29(4).En:http:// www.cpimtz.sld.cu/revista%20medica/ano%202007/vol4%202007/ tema13.htm

Rincón D, Valero J. Prevención de la náusea y el vómito postoperatorios. Rev Col Anest 2007; 35: 293-300.

Fujii, Y. The Utility of antiemetics in the prevention and treatment of postoperative nausea and vomiting in aatients scheduled for laparoscopic cholecystectomy. Current Pharmaceutical Design 2005; 11: 3173-3183.

Teran L, Hawkin J. The effectiveness of inhalation isopropyl alcohol vs granisetron for the prevention of postoperative nausea and vomiting. AANA J 2007; 75: 417-422.

Hamdan G. Midazolam: Un antiemético efectivo después de la cirugía cardíaca. Anesth Analg 2004; 99:339-43.

Sánchez M, López L, Pueyo F, Carrascosa F, Ortega A. A comparison of three antiemetic combinations for the prevention of postoperative nausea and vomiting. Anesth Analg 2002; 95:1590–1595.

De la Torre A, Rubial M. Anestesia en cirugía ambulatoria. Criterios de alta hospitalaria. ANALES Sis San Navarra 1999; 22: 101-106.

Oksuz H, Zencirci B, Ezberci M. Comparison of the effectiveness of metoclopramide, ondasetron, and granisetron on the prevention of nausea and vomiting after laparoscopic cholecystectomy. J Laparoendosc Adv Surg Tech A. 2007 17: 6.

Lee A, Gin T, Lau A, Floria F. A Comparison of patients and health care professionals preferences for symptoms during immediate postoperative recovery and the management of postoperative nausea and vomiting. Anesth Analg 2005; 100:87–93.

Fujii, Y. Prophylaxis of postoperative nausea and vomiting in patients scheduled for breast surgery. Clin Drug Invest 2006; 26: 427-437.

Hannaoka K, Toyooka H, Ohashi Y. Efficacy of profilactic intravenous granisetron in postoperative emesis in adults. J Anesth 2004; 18:158165.

Kovac A. Management of postoperative nausea and vomiting in children. Pediatr Drugs 2007; 9: 47-69.

Ramírez D, Ros J. Prevención de las náuseas y vómitos postoperatorios en cirugía ginecológica mediante tres dosis fijas de metoclopramida, droperidol o placebo. Rev Esp Anestesiol 2001; 48: 2.

McKeage K, Simpson D, Wagstaff, A. Intravenous droperidol: A review of its use in the management of postoperative nausea and vomiting. Drugs 2006; 66: 2123-2147.

Piper S, Suttner S, Röhm K, Maleck W, Larbig E, Boldt J. Dolasetron, but not metoclopramide prevents nausea and vomiting in patients undergoing laparoscopic cholecystectomy. Can J Anesth 2002; 49: 1021–1028.

Abali H, Elik I. Tropisetron, ondansetron, and granisetron for control of chemotherapy-induced emesis in turkish cancer patients: A comparison of efficacy, side-effect profile, and cost. Cancer Invest 2007; 25:135–139.

Quaynor H, Raeder J. Incidence and severity of postoperative nausea and vomiting are similar after metoclopramide 20mg and ondansetron 8mg given by the end of laparoscopic cholecystectomies. Rev Acta Anaesthesiol Scand 2002; 46: 109–113.

Gupta V, Wakhloo R, Lahori V. Prophylactic antiemetic therapy with ondansetron, granisetron and metoclopramide in patients undergoing laparoscopic cholecystectomy under general anaesthesia. Internet Journal of Anesthesiology 2007; 14 :1-5.

Aapro M, Thuerlimann B. A randomized double-blind trial to compare the clinical efficacy of granisetron with metoclopramide both combined with dexamethasone in the prophylaxis of chemotherapyinduced delayed emesis. Ann Onc 2003; 14: 291-297.

Apfel C, Korttila K, Abdalla M, Kerger H, Turan A, Vedder I, Zernak C, et al. A factorial trial of six Interventions for the prevention of postoperative nausea and momiting. N Engl J Med 2004; 350: 24412451.

Hamadani M, Chaudhary L, Awan F, Khan J, Kojouri K, Ozer H, et al. Management of platinum-based chemotherapy induced acute nausea and vomiting: is there a superior serotonin receptor antagonist?. J Oncol Pharm Practice 2007; 13: 2.

Elhakim M, Nafie M, Mahmoud K, Atef A. Dexamethasone 8 mg in combination with ondansetron 4 mg appears to be the optimal dose for the prevention of nausea and vomiting after laparoscopic cholecystectomy. Can J Anesth 2002; 49: 922–926.

Smith I, Walley G, Bridgman. Omitting fentanyl reduces nausea and vomiting, without increasing pain, after sevoflurane for day surgery.

Eur J Anaesthesiol 2008 25: 790-799.

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Publicado

2010-06-14

Cómo citar

Apuy Roldàn, N., Chaverri Fernàndez, J. M., Monge Aguilera, M., & Zavaleta Monestel, E. (2010). Characterization of the Use of Antiemetics in the Postoperative Period in Adult Patients Undergoing Surgery during January to May 2009 in a private hospital, Clínica Bíblica, in Costa Rica. Acta Médica Costarricense, 52(3), 167–172. https://doi.org/10.51481/amc.v52i3.745