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Ondansetron is more effective than metoclopramide for the treatment of opioid-induced emesis in post-surgical adult patients

Published online by Cambridge University Press:  16 August 2006

F. Chung ,
R. Lane ,
C. Spraggs ,
B. McQuade ,
M. Jacka ,
H. H. Luttropp ,
S. Alahuta ,
S. Rocherieux ,
M. Roy  and
P. Duvaldestin
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F. Chung
Affiliation:
Department of Anaesthesia, Toronto Western Division, Toronto Hospital, Ontario, Canada
R. Lane
Affiliation:
Department of Oncology Clinical Research, Glaxo Wellcome Research and Development, Greenford, UK
C. Spraggs
Affiliation:
Department of Oncology Clinical Research, Glaxo Wellcome Research and Development, Greenford, UK
B. McQuade
Affiliation:
Department of Oncology Clinical Research, Glaxo Wellcome Research and Development, Greenford, UK
M. Jacka
Affiliation:
Department of Anaesthesia, Saint John Regional Hospital, 400 University Avenue, Saint John NB, E2L 4L2, Sweden
H. H. Luttropp
Affiliation:
Department of Anaesthesiology and Intensive Care, University Hospital, Lund, Sweden
S. Alahuta
Affiliation:
Oulu University Hospital, Department of Anaesthesiology, Oulu, Finland
S. Rocherieux
Affiliation:
Clinique Du Parc, 12 Allée Des Tilleuls, Chambray-Les-Tours, France
M. Roy
Affiliation:
Department of Anaesthetics, Hartlepool General Hospital, Cleveland, UK
P. Duvaldestin
Affiliation:
Hopital Henri Mondor, Service Anesthesie-Reanimation, 51 Av. Du M De Lattre De Tassigny, Creteil, France
P. Curtis
Affiliation:
Department of Medical Statistics, Glaxo Wellcome Research and Development, Greenford, UK.
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Abstract

Nausea and vomiting are common side effects of opioids administered for pain control. This double-blind, randomized, parallel-group study evaluated the anti-emetic efficacy and tolerability of single intravenous (i.v.) doses of ondansetron 8 mg, ondansetron 16 mg and metoclopramide 10 mg in the treatment of opioid-induced emesis. Adult patients undergoing low emetogenic surgical procedures, using a standardized anaesthesia regimen were assessed for 24 h following administration of study anti-emetic to treat established post-surgical opioid-induced emesis. A total of 4511 patients were enrolled of whom 1366 experienced opioid-induced emesis and received randomized study medication. Ondansetron 8 mg and 16 mg were significantly better than metoclopramide 10 mg (P < 0.05) for both complete control of emesis, complete control of nausea and other efficacy measures. There were no significant differences between the two ondansetron groups. All three treatments were well tolerated. In conclusion, this large, multicentre study demonstrates that ondansetron is more effective than metoclopramide in the treatment of opioid-induced emesis following administration of post-surgical opioids to control pain.

Keywords

opioid-induced emesisondansetronmetoclopramidepost-surgical patientsnauseavomiting
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 16 , Issue 10 , October 1999 , pp. 669 - 677
Copyright
1999 European Society of Anaesthesiology

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