Transdermal scopolamine patch in addition to ondansetron for postoperative nausea and vomiting prophylaxis in patients undergoing ambulatory cosmetic surgery.

STUDY OBJECTIVE

To determine the efficacy of transdermal scopolamine in addition to ondansetron in decreasing the incidence of postoperative nausea and vomiting (PONV).

DESIGN

Randomized controlled trial.

SETTING

Academic hospital.

PATIENTS

126 ASA physical status I and II patients undergoing outpatient plastic surgery with three or more risk factors for PONV.

INTERVENTIONS

Patients were randomly assigned to one of two groups to receive (Group 1) a transdermal scopolamine (TDS) patch or (Group 2), a placebo patch two hours before surgery.

MEASUREMENTS

Occurrence of vomiting, severity of nausea using a visual analog scale (VAS), rescue medication, pain intensity and pain medications, and side effects were recorded every hour until discharge from hospital, then every 4 hours thereafter for a total of 24 hours.

MAIN RESULTS

A statistically significant reduction in postoperative nausea between 8 and 24 hours in patients receiving TDS was noted.

CONCLUSIONS

Transdermal scopolamine in addition to ondansetron benefits patients at high risk for PONV undergoing outpatient plastic surgery for up to 20 hours after surgery.