86937
document
Recovery profile after desflurane with or without ondansetron compared with propofol in patients undergoing outpatient gynecological laparoscopy . We studied the effect of combining prophylactic ondansetron ( 4 mg intravenously [ IV ] ) to desflurane-based anesthesia in 90 ASA grade I or 11 women undergoing outpatient gynecological laparoscopy . Recovery after anesthesia , with special focus on postoperative nausea and vomiting ( PONV ) , was assessed . Control groups received a similar desflurane anesthetic ( placebo ) or a propofol-infusion-based ( active control ) anesthetic . The study design was randomized , controlled , and double-blind ( regarding ondansetron ) and single-blind ( regarding the anesthetic technique ) . Early recovery ( eye opening , orientation , following commands , sitting ) was similar in the three groups . However , overall home readiness ( toleration of oral fluids , walking , pain tolerable by oral analgesics , no or only mild nausea ) was achieved faster in the desflurane group receiving ondansetron ( 109 [ 21-937 ] min , P < 0.01 ) and in the propofol group ( 110 [ 33-642 ] min , P < 0.001 ) when compared to the desflurane only group ( 372 [ 45-723 ] min ) ( median [ range ] ) . The total incidence of PONV in the desflurane-only group was 80 % ( P < 0.01 ) , compared to 40 % and 20 % in the desflurane group receiving ondansetron and the propofol group , respectively . The postoperative antiemetic requirements were consistently and significantly ( P < 0.01 ) higher in the desflurane-only group compared to the other two groups . Postoperative sedation , analgesic requirements , and psychomotor recovery ( assessed by the Maddox Wing and the Digit Symbol Substitution Tests ) were similar in the three groups . Our results suggest that in order to achieve a propofol-like recovery profile in patients with a high likelihood of PONV , desflurane should be combined with a potent antiemetic ( e.g. , ondansetron ) .
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Intervention_Pharmacological
desflurane with or without ondansetron
86939
Intervention_Pharmacological
propofol
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Intervention_Pharmacological
prophylactic ondansetron
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Intervention_Pharmacological
desflurane-based anesthesia
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Intervention_Surgical
gynecological laparoscopy
86943
Intervention_Control
desflurane anesthetic ( placebo )
86944
Intervention_Pharmacological
propofol-infusion-based ( active control ) anesthetic
86945
Intervention_Pharmacological
ondansetron
86946
Intervention_Pharmacological
ondansetron
86947
Intervention_Pharmacological
desflurane
86948
Intervention_Pharmacological
desflurane-only
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Intervention_Pharmacological
desflurane
86950
Intervention_Pharmacological
propofol
86951
Intervention_Pharmacological
desflurane-only
86952
Intervention_Pharmacological
propofol-like
86953
Intervention_Pharmacological
desflurane
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Outcome_Physical
home readiness
86955
Outcome_Physical
PONV
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Outcome_Physical
postoperative antiemetic requirements
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Outcome_Physical
Postoperative sedation , analgesic requirements , and psychomotor recovery
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Outcome_Other
propofol-like recovery profile
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Participant_Condition
outpatient gynecological laparoscopy
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Participant_Sex
women