Journal of Anesthesia

, Volume 27, Issue 6, pp 879–884

Antiemetic effect of naloxone in combination with dexamethasone and droperidol in patients undergoing laparoscopic gynecological surgery

  • Yoshihiro Kasagi
  • Masakazu Hayashida
  • Yusuke Sugasawa
  • Iwaho Kikuchi
  • Keisuke Yamaguchi
  • Ryu Okutani
  • Satoru Takeda
  • Eiichi Inada
Original Article

Abstract

Purpose

We examined the effects of dexamethasone, droperidol, naloxone, and a combination of these three agents on postoperative nausea and vomiting (PONV) in female patients.

Methods

In this randomized, controlled study, 120 female patients with ASA PS I or II undergoing laparoscopic gynecological surgery were randomly allocated into four groups. Patients received dexamethasone 8 mg (Dx group) or droperidol 1 mg (Dr group) before induction of general anesthesia. Anesthesia was induced and maintained with propofol and remifentanil. Postoperative analgesia was provided by intravenous patient-controlled analgesia using a disposable infusion pump filled with fentanyl 20 μg/kg alone (Dx group), fentanyl 20 μg/kg with droperidol 2 mg (Dr group), fentanyl 20 μg/kg with naloxone 0.1 mg (Nx group), or fentanyl 20 μg/kg with droperidol 2 mg and naloxone 0.1 mg (Cm group) in a total volume of 80 ml, with a constant infusion rate of 4 ml/h and a bolus dose 2 ml with a 30-min lockout time.

Results

The number of patients who developed PONV and required a rescue antiemetic was significantly less in the Cm group than in the Nx group (p < 0.001 for all). The incidence of PONV was 43, 43, 70, and 17 % in the Dx, Dr, Nx, and Cm groups, respectively.

Conclusion

A combination of naloxone, droperidol, and dexamethasone was effective for preventing PONV in patients receiving fentanyl for postoperative analgesia after laparoscopic gynecological surgery, although further investigations are required to examine the effect of adding naloxone to other antiemetics.

Keywords

Laparoscopic surgery Postoperative nausea and vomiting Dexamethasone Droperidol Naloxone 

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Copyright information

© Japanese Society of Anesthesiologists 2013

Authors and Affiliations

  • Yoshihiro Kasagi
    • 1
    • 3
  • Masakazu Hayashida
    • 1
  • Yusuke Sugasawa
    • 1
  • Iwaho Kikuchi
    • 2
  • Keisuke Yamaguchi
    • 1
  • Ryu Okutani
    • 3
  • Satoru Takeda
    • 2
  • Eiichi Inada
    • 1
  1. 1.Department of Anesthesiology and Pain MedicineJuntendo University Faculty of MedicineTokyoJapan
  2. 2.Department of Obstetrics and GynecologyJuntendo University Faculty of MedicineTokyoJapan
  3. 3.Department of AnesthesiologyOsaka City General Hospital and Children’s HospitalOsakaJapan

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