PONV drug choice

Started by coh, January 06, 2007, 05:07:04 PM

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What medicine whould you use to prevent PONV?

Metoclopramid (PRAMIN)
Ondansteron
Dexametasone
Droperidol
Propofol (small doses)

coh

Post-operative nausea and vomiting (PONV)

Practicing anesthesiologists please answer the Qs and write your status (consultant,specialist, resident and etc)

frontier

hi,
its difficult to choose a single drug.almost all of them can be used.but the best choice will be 5HT3 antagonists like ondensetron,granisetronetc.next metoclopramide can be used if 5HT3 antagonist not available.if PONV is refractory to single drug therapy then it will respond to dexamethasone+5ht3 ANTAGONIST.regarding droperidol i don't have much idea.propofol offcourse is an antiemetic.

kumar

Quote from: coh on January 06, 2007, 05:07:04 PM
Post-operative nausea and vomiting (PONV)

Practicing anesthesiologists please answer the Qs and write your status (consultant,specialist, resident and etc)
dexamethasone and ondensetron 100% effective. I am consultant in nero anesthesia

yogenbhatt1

        I am a consultant in private practice in Mumbai with a group of 5  qualified anaesthesiologists and 3 trained technicians. ( You requested us to give our status)
         A hospital where we practice, the surgeon says that Vomiting is the lousiest sensation in the world. See that my patients do not vomit.
We routeinly give all possible drugs that are known to reduce PONV.
We give Metoclopromid, Ranitidine, Ondensetron and even Dexona, but the PONV rate was still high specially in Obstatric cases, mainly when Prostodin was given.
After changing over to Granisetron instead of Ondensetron, our PONV rate is almost nil.

jafo1964

Ondansetron - prolonged QT interval and cost effectiveness
Does it worry you
we use buprenorphine in all our CNB for post-op analgesia.
In the few rare cases that end up with PONV even Ondansetron 8mg IV tds is of no use
Droperidol might be a rescue antiemetic in such situations but have no expereince working with that drug