Antiemetic Drugs
Particularly useful for patients undergoing these procedures,with a history of nausea, vomiting or motion sickness, or obese patients: opthalmological surgery, laproscopic surgery or gynecologic procedures
If not desirable for preanesthetic medication, drugs may be administered IV at the conclusion of surgery.
Some drug options:
Droperidol:
low doses; administered usually IV -- prevents postoperative nausea/vomiting
Some reports: droperidol better than either metoclopramide or domperidone
Droperidol reported useful as antiemetic for patients having cesarean section using spinal anesthesia
Low doses: not always effective -- higher doses (at the end of surgery) may cause excessive recovery room sedation
Metoclopramide (Reglan)
inconsistent, controversial for preoperative use
5-HT3 receptor antagonist (serotonin antagonist)
Administration: IV, 4-8 mg {adult} before induction: highly efficacious in preventing postoperative nausea/vomiting
Should be used selectively
Other drugs:
phenothiazines (e.g.,prochlorperazine); hydroxyzine;diphenidol
Moyers, J.R., Preoperative Medication, Chapter 21, In: Clinical Anesthesia 3rd edition, (Barash, P.G., Cullen, B.F. and Stoelting, R.K., eds) Lippincott-Ravin, Philadelphia, New York, 1997, pp. 519-529