Abstract

APUY-ROLDAN, Natalia; CHAVERRI-FERNANDEZ, José Miguel; MONGE-AGUILERA, Mónica  and  ZAVALETA-MONESTEL, Esteban. Characterization of the Use of Antiemetics in the Postoperative Period in Adult Patients Undergoing Surgery During January to May 2009 in a private hospital Clínica Bíblica in Costa Rica. Acta méd. costarric [online]. 2010, vol.52, n.3, pp.167-172. ISSN 0001-6002.

Aim: To evaluate and characterize the pharmaco-therapeutic approach with antiemetics during the postoperative, in adult patients undergoing surgery at a private hospital in Costa Rica (Hospital Clinica Biblica) Methods:This is an observational, prospective and cohort study. Those patients who had surgery and received antiemetic prophylaxis before the procedure were selected (ages between 18 and 75 years) excluding those who had hospitalization shorter than 24 hours. Results: Prophylactic antiemetic therapy in this private hospital utilizes granisetron, metoclopramide, dexamethasone, and dimenhydrinate, Granisetron, either alone or in combination, was the most used antiemetic in 81%. The combination most commonly used was dexamethasone and granisetron (57%). Without considering the surgical procedure, the incidence of postoperative nausea and vomiting (PONV) was 12% in patients taking granisetron, 25% with metoclopramide, 9% with dimenhydrinate, 13% with dexamethasone and 14% with other antiemetics. On the other hand, looking at the procedure, the incidence of PONV in patients undergoing orthopedic surgery was by 30%, and 28% in those after laparoscopic surgery Finally, in cases in which fentanyl was used as an anesthetic 18% of the patients presented PONV, whereas in patients cases were fentanyl was not used, the rate of was 9%. Conclusion: Despite the widespread use of prophylactic antiemetics, PONV is still seen in the patients at this private hospital. In spite of the wealth of knowledge in this field, physicians have not yet found an algorithm capable of the total prevention of PONV. Individual risks and patient`s satisfaction should be taken into account. Further research on this matter must continue in order to unify and improve criteria of PONV treatment.

Keywords : nausea; vomiting; postoperative; anesthetics; antiemetics; postoperative nausea and vomiting.

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