Does esomeprazole prevent post-operative nausea and vomiting?
| Autor: | R. Bergheim, Vegard Dahl, J. Kilhamn, E. Bjoernestad, E. Naucler, Johan Raeder, G. Edlund, S. Modin |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Nausea medicine.drug_class Proton-pump inhibitor Placebo Fentanyl Esomeprazole Placebos Double-Blind Method Anesthesiology Risk Factors medicine Humans Antiemetic Aged Analysis of Variance business.industry Proton Pump Inhibitors General Medicine Middle Aged medicine.disease Anesthesiology and Pain Medicine Pulmonary aspiration Anesthesia Postoperative Nausea and Vomiting Vomiting Antiemetics Female medicine.symptom business medicine.drug |
| Zdroj: | Acta Anaesthesiologica Scandinavica. 51:217-225 |
| ISSN: | 1399-6576 0001-5172 |
| DOI: | 10.1111/j.1399-6576.2006.01179.x |
| Popis: | Background: Esomeprazole is a potent proton pump inhibitor (PPI), reducing acid production as well as gastric juice volume. This study evaluated the possible beneficial effect of esomeprazole on reducing post-operative nausea and vomiting (PONV). Methods: Patients undergoing laparoscopic or open gynaecological surgery, or laparoscopic cholecystectomy were randomized to receive three peri-operative doses double blindly of either esomeprazole 40 mg or placebo, given intravenously or orally. All patients were given a standardized anaesthesia regimen including fentanyl and sevoflurane/nitrous oxide. Results: The study population consisted of 284 patients. Demographic data and known PONV risk factors were similar for the two treatment groups. PONV was observed in 77% of patients on esomeprazole vs. 81% on placebo (NS) and rescue antiemetic medication was needed in 56% vs. 53%, respectively (NS). The proportion of patients that vomited during 0–24 h was lower on esomeprazole than placebo (38% vs. 49%; NS), and the mean amount of vomit was significantly lower (52 vs. 86 g; P < 0.05). The use of neostigmine, use of opioids and type of surgery were significant risk factors for PONV (P < 0.05). The 24-h incidence of PONV was 63% after laparoscopic gynaecology, 80% after laparoscopic cholecystectomy and 88% after open gynaecological laparotomy, whereas laparoscopic cholecystectomy had the lowest risk when corrected for other risk factors of PONV. Conclusion: Esomeprazole had no clinically relevant effect on the overall 24-h incidence of PONV. However, esomeprazole significantly reduced the total amount of vomit during 24-h post-operatively. This may be of value in patients with an increased risk of pulmonary aspiration. |
| Databáze: | OpenAIRE |
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