Treatment of postoperative nausea and vomiting after outpatient surgery with the 5-HT3 antagonist ondansetron

P. Scuderi, B. Wetchler, Y. F. Sung, M. Mingus, S. DuPen, L. Claybon, J. Leslie, P. Talke, J. Apfelbaum, S. Sharifi-Azad, M. F. Williams

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119 Scopus citations


Background: Postoperative nausea and vomiting following outpatient surgery can significantly delay discharge. This study evaluates the safety and efficacy of ondansetron (a new 5-HT3 antagonist) in the treatment of postoperative nausea and vomiting in patients following outpatient surgery. Methods: Five hundred outpatient surgical patients (53 male and 447 female), receiving general endotracheal anesthesia, were studied at ten centers. Patients were stratified by gender and received, in a randomized, double- blind manner, 1, 4, or 8 mg ondansetron or placebo in response to nausea and/or vomiting postoperatively. Episodes of vomiting, nausea scores, adverse events, vital signs, and laboratory values were evaluated before and during the 24 h after study drug administration. Results: Complete response to study medication (no vomiting and/or retching, and no rescue antiemetic over the initial 0-2-h period) was more frequent in the ondansetron groups (1 mg 57%, 4 mg 61%, and 8 mg 57%) than in the placebo group (30%, P < .001). For the 0- 24-h study a complete response occurred in only 15% of the placebo group compared to 41%, 47%, and 47% of the 1-, 4-, and 8-mg ondansetron groups, respectively (P < .001 for all comparisons with placebo). Median nausea scores (range 0-10) during the initial observation period (0-2 h) were significantly lower for all doses of ondansetron (1.3, 0.8, 1.8 for 1, 4, and 8 mg, respectively) as compared with placebo (2.3). No significant differences occurred in hemodynamic stability, incidence of adverse events, or changes in laboratory values in the ondansetron groups compared to the placebo group. Conclusions: Ondansetron, in doses less than 8 mg, is a safe, effective antiemetic for treating postoperative nausea and vomiting.

Original languageEnglish (US)
Pages (from-to)15-20
Number of pages6
Issue number1
StatePublished - 1993


  • Antagonists, serotonin: ondansetron
  • Complications, postoperative: nausea; vomiting
  • Receptors, 5-HT: serotonin

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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