Effect of Ondansetron alone or in Combination with Dehydrobenzperidole and Dexamethasone on Discharge Time Following Gynecological Laparoscopy

We aimed to examine a possible accelerated discharge time after gynecological laparoscopy when treated with a combination of ondansetron, dehydrobenzperidole and dexamethasone as compared to ondansetron alone. Sixty ASA 1-2 women were included in this prospective double-blind study and were randomised to either peroperative ondansetron 4 mg, dehydrobenzperidole 0.625 mg and dexamethasone 8 mg or to ondansetron 4 mg only. General anaesthesia was induced by fentanyl, propofol, mivacurium and maintained by sevoflurane in 50% oxygen. Patients were tracheal intubated and had a orogastric tube during the laparoscopy. The neuromuscular block was allowed to wear of without the use of neostigmine. In case of postoperative nausea and vomiting in the ondansetron only group, escape medication with dehydrobenzperidole and dexamethasone was given. The discharge criteria at the day surgery unit were fulfilled at 7h 45min (range 3h 10min - 24h 16min) after the end of surgery in the women treated with ondansetron only, but was accelerated to 5h 11min (range 3h 9min – 21h 8min) in the women having peroperative treatment with both ondansetron, dehydrobenzperidole and dexamethasone (p<0.01). Postoperative nausea and vomiting was evident in 4% at arrival at day surgery recovery after treatment with the triple combination, but in 16% in the patients treated with ondansetron alone (p<0.01). In conclusion, peroperative treatment with a combination of ondansetron, dehydrobenzperidole and dexamethasone allows a significantly accelerated discharge time after gynecological laparoscopy and causes a significantly reduced incidence of nausea and vomiting.