British Journal of Anaesthesia, 2003, Vol. 91, No. 4 589-592
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia
Short Communications |
Cost-effectiveness of three combinations of antiemetics in the prevention of postoperative nausea and vomiting
1 Department of Anaesthesiology and Critical Care and 2 Department of Pharmacology, University Clinic, School of Medicine, University of Navarra, Avda. Pio XII 36, E-31007, Pamplona, Spain
Corresponding author. E-mail: llolaond@unav.es
Background. This study compares the cost-effectiveness of three combinations of antiemetics in the prevention of postoperative nausea and vomiting (PONV).
Methods. We conducted a prospective, double-blind study. Ninety ASA I–II females, 18–65 yr, undergoing general anaesthesia for major gynaecological surgery, with standardized postoperative analgesia (intrathecal 0.2 mg plus i.v. PCA morphine), were randomly assigned to receive: ondansetron 4 mg plus droperidol 1.25 mg after induction and droperidol 1.25 mg 12 h later (Group 1); dexamethasone 8 mg plus droperidol 1.25 mg after induction and droperidol 1.25 mg 12 h later (Group 2); ondansetron 4 mg plus dexamethasone 8 mg after induction and placebo 12 h later (Group 3). A decision analysis tree was used to divide each group into nine mutually exclusive subgroups, depending on the incidence of PONV, need for rescue therapy, side effects and their treatment. Direct cost and probabilities were calculated for each subgroup, then a cost-effectiveness analysis was conducted from the hospital point of view.
Results. Groups 1 and 3 were more effective (80 and 70%) than Group 2 (40%, P=0.004) in preventing PONV but also more expensive. Compared with Group 2, the incremental cost per extra patient without PONV was €6.99 (95% CI, –1.26 to 36.57) for Group 1 and €13.55 (95% CI, 0.89–132.90) for Group 3.
Conclusion. Ondansetron+droperidol is cheaper and at least as effective as ondansetron+ dexamethasone, and it is more effective than dexamethasone+droperidol with a reasonable extra cost.
Br J Anaesth 2003; 91: 589–92
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  C.-C. Chu, J.-P. Shieh, J.-I. Tzeng, J.-Y. Chen, Y. Lee, S.-T. Ho, and J.-J. Wang The Prophylactic Effect of Haloperidol Plus Dexamethasone on Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopically Assisted Vaginal Hysterectomy Anesth. Analg., May 1, 2008; 106(5): 1402 - 1406. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Richman, S. S. Liu, G. Courpas, R. Wong, A. J. Rowlingson, J. McGready, S. R. Cohen, and C. L. Wu Does Continuous Peripheral Nerve Block Provide Superior Pain Control to Opioids? A Meta-Analysis Anesth. Analg., January 1, 2006; 102(1): 248 - 257. [Abstract] [Full Text] [PDF]
|
|