Effect of Addition of Ondansetron for PONV Prophylaxis in Ambulatory Hysteroscopy with Propofol Total Intravenous Anesthesia

Abstract

Background: In female patients undergoing hysteroscopy
in outpatient unit, total intravenous anesthesia (TIVA)
technique with propofol is frequently used as induction and
maintenance drug. Ondansetron is often given as an
antiemetic drug even if propofol infusion has proven to
have antiemetic effect. We hypothesized that the addition
of ondansetron prophylaxis does not alter incident of
postoperative nausea and vomiting (PONV) and post
discharge nausea and vomiting (PDNV) in patients
undergoing hysteroscopy with propofol TIVA technique in
the ambulatory setting.
Method: One hundred and ten female adult patients
scheduled for hysteroscopy in an ambulatory setting were
randomized into a control group (C group) who did not
received any antiemetic drug other than propofol infusion
and an ondansetron group (O group) who received
4 milligrams of ondansetron after induction. Patients’
baseline characteristics, including Apfel’s score, duration

of anesthetic and surgical procedure, and dose of any
drug given were recorded. The incidence of PONV was
recorded in PACU and 2-day incidence of PDNV was
gathered by telephone interview within 2 weeks.
Results: There were no incidences of PONV reported in
PACU in both groups (P>0.99). The overall incidences of
PDNV were lower in the control group, but not statistically
significant (14% vs 5.9%; P=0.2). Daily incidences of
PDNV had no statistic differences. Pain scores, inpatient
admissions, and other complication incidences had no
significant differences.
Conclusion: Addition of ondansetron prophylaxis does not
alter incident of PONV and PDNV in patients undergoing
hysteroscopy with propofol TIVA technique in the
ambulatory setting.