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British Journal of Anaesthesia, 2003, Vol. 90, No. 2 194-198
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Laboratory Investigations

Dolasetron prophylaxis reduces nausea and postanaesthesia recovery time after remifentanil infusion during monitored anaesthesia care for extracorporeal shock wave lithotripsy

M. A. Burmeister*, T. G. Standl, M. Wintruff, P. Brauer, I. Blanc and J. Schulte am Esch

Department of Anesthesiology, University Hospital Hamburg-Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany

Corresponding author. E-mail: burmeister@uke.uni-hamburg.de
Declaration of interest. The work was supported by Aventis Pharma, Germany and included payment of patients insurance and the fee of the local ethics committee.
{dagger}Results of this work have been presented at the German Congress of Anesthesiology in Munich, May 2000 and at the Annual Meeting of the ASA, in San Francisco, October 2000.

Background. Remifentanil is used as an analgesic for different procedures performed during monitored anaesthesia care. Opioid-induced nausea and vomiting can be troublesome.

Methods. This prospective, randomized, double-blind study was performed to evaluate the efficacy of prophylaxis with dolasetron in reducing the frequency of postoperative nausea and duration of discharge time. Forty urological patients, undergoing elective ambulatory extracorporeal shock wave lithotripsy (ESWL) received randomly either dolasetron 12.5 mg i.v. (Group 1) or placebo (Group 2) 10 min before a patient-adapted continuous infusion of remifentanil 0.15–0.4 µg kg–1 min–1 was administered. Frequency and intensity (VAS 0–100 mm) of nausea, retching, and vomiting were assessed by patients and blinded investigators during and after the procedure.

Results. Patient characteristics, baseline values, duration of ESWL, and total dose of remifentanil did not differ between groups. The frequency (Group 1/Group 2; 20/55%; P<0.05) and mean (SD) maximal intensity [15 (9)/45 (14) mm; P<0.05] of nausea during 24 h was significantly reduced after dolasetron and discharge times in Group 1 were less than Group 2 [22 (14)/45 (28) min; P<0.05].

Br J Anaesth 2003; 90: 194–8


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