Effect of timing of ondansetron administration on its efficacy as a prophylactic antiemetic in patients undergoing gynecological laparoscopic procedures

Although ondansetron (4 mg IV) is effective in the prevention and treatment of postoperative nausea and vomiting (PONV) after gynecological laparoscopic surgery, the optimal timing of its administration, and the effect on the patient's quality of life after discharge have not been established.

In this placebo-controlled study, 90 healthy women undergoing gynecological laparoscopic procedures were randomized to receive placebo (Group A), ondansetron 4 mg before induction (Group B), and ondansetron 4 mg at the end of surgery (Group C).

Compared with placebo and ondansetron given before induction of anesthesia, ondansetron administered after surgery was associated with lower nausea, decrease incidence of emesis (more than two episodes), earlier intake of normal fluid and food during first 24 hours post operatively. This prophylactic regimen was also associated with highest patient satisfaction.

Compared with placebo and ondansetron given before induction of anesthesia, ondansetron administered after surgery significantly reduced the incidence of PONV in the post anesthesia care unit and during the 24-h follow-up period, it also facilitated the recovery process by reducing the time to oral intake for fluid and a normal diet. It also improves patient's quality of life after surgery.