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 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
    •  Ondansetron: (Zofran)
      • 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