Intravenous Ondansetron as Antiemetic Prophylaxis for Postoperative Nausea and Vomiting after Shoulder Arthroscopy

Background: Nausea and vomiting are common chief postoperative complaints. The clinicalliterature indicates that postoperative nausea and vomiting (PONV) iscommon after orthopedic surgery. This study examines the clinical therapeuticefficacy of Ondansetron injected intravenously before the end of shoulderarthroscopy as antiemetic prophylaxis to help reduce the incidence of PONV.Methods: Participants were identified through retrospective chart review and patientsundergoing shoulder arthroscopy performed by the same orthopedic surgeonat the same hospital from 2005 to 2009 were analyzed. Subjects were classifiedinto two groups based on whether Ondansetron was given. Differencesin the incidence of PONV among the two groups were compared. Basicpatient information, anesthesia records, and surgical records were obtained,as well as records on PONV, postoperative pain intensity, and postoperativeanalgesic injections within 24 hours after surgery.Results: The study involved 90 patients. The Group A contained 34 patients who didnot receive Ondansetron, and the Group B contained 56 patients who weregiven Ondansetron. Analytical results for the postoperative 24 hour periodshowed a significant difference in the incidence of vomiting between the twogroups, with a lower incidence (p < 0.05) for the. Group B. However therewas no significant difference in the incidence of nausea between the twogroups in the same postoperative 24 hour period, although there was a trendof a lower incidence in the Group B (p = 0.17). The overall incidence ofPONV during the 24-hour period was lower in the Group B (14%) than theGroup A (32%), and the Group B demonstrated lower pain intensity andlower analgesic injection needs.Conclusion: Routine intravenous injection of Ondansetron 30 minutes before completionof shoulder arthroscopy can reduce the incidence of vomiting and overallPONV in patients. Additionally, the patients using Ondansetron demonstratedlower pain intensity and lower analgesic injection needs than the controlgroup.