Abstract

CONTRERAS-DOMINGUEZ, Víctor  and  CARBONELL-BELLOLIO, Paulina. Prophylactic antiemetic therapy for acute abdominal surgery: a comparative study of droperidol, metoclopramide, tropisetron, granisetron and dexamethasone. Rev. Bras. Anestesiol. [online]. 2008, vol.58, n.1, pp. 35-44. ISSN 0034-7094.  http://dx.doi.org/10.1590/S0034-70942008000100005.

BACKGROUND AND OBJECTIVES: It is calculated that the incidence of postoperative nausea and vomiting (PONV) is approximately 30%. The prophylaxis of PONV has been the subject of several studies, both to decrease this problem and to compare the cost-benefit ration of the treatment used. The objective of this study was to compare the efficacy of 5 antiemetic drugs with a control group in emergency appendectomy. METHODS: A controlled, double-blind, prospective study with 150 patients, ASA I and II, BMI < 30, undergoing appendectomy, was undertaken. Patients were divided in six groups: Group 1 (n = 25): 5 mL of normal saline; Group 2 (n = 25): 0.625 mg of droperidol; Group 3 (n = 25): 20 mg of metoclopramide; Group 4 (n = 25): 5 mg of tropisetron; Group 5 (n = 25): 1 mg of granisetron; Group 6 (n = 25): 4 mg of dexamethasone. Monitoring included ECG, non-invasive blood pressure, O₂ saturation, P_ETCO₂, anesthetic gas analyzer and peripheral nerve stimulator. The presence of PONV, complications and the degree of satisfaction in the first 48 hours were evaluated. RESULTS: The incidence of PONV in the droperidol group was 4% while in the granisetron, tropisetron and metoclopramide groups it was 12% (p < 0.05). The dexamethasone group had a 24% incidence and the control group 28%. CONCLUSIONS: Low doses of droperidol were more effective in the prophylaxis of PONV in emergency appendectomy than the other drugs.

Keywords : ANTIEMETICS [dexamethasone]; ANTIEMETICS [droperidol]; ANTIEMETICS [granisetron]; ANTIEMETICS [metoclopramide]; ANTIEMETICS [tropisetron]; COMPLICATIONS [nausea]; COMPLICATIONS [vomiting]; SURGERY [appendectomy]; SURGERY [emergency].