The effect of ondansetron on analgesic efficacy of acetaminophen after hysterectomy: A randomized double blinded placebo controlled trial

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Date

2017

Journal Title

Journal ISSN

Volume Title

Publisher

Elsevier Science Inc

Access Rights

info:eu-repo/semantics/closedAccess

Abstract

Objectives: To determine that perioperative ondansetron reduces the analgesic efficacy of acetaminophen. Design: Randomized, double-blinded study. Patients: 120 patients ASA I-II who underwent abdominal hysterectomy. Interventions: All the patients were given 1 g acetaminophen at skin closure. Patients were divided into two groups; ondansetron HCI (8 mg, 2 ml IV) (Group I, N = 60) and saline (2 ml IV) (Group II, N = 60) at the skin closure. Measurement: Postoperative pain scores (VAS) while resting in bed and sitting, total opioid consumption were noted. Main results: Patients randomized to ondansetron had significantly worse pain scores upon arrival to the recovery unit [by 1.7 (99.7% CI: 0.75, 2.59) cm] and at 1 h [by 13 (0.5, 2.1) cm] while resting in bed. Pain scores while sitting were also significantly greater in ondansetron group at arrival in PACU by 0.6 (99.7% CI: 0.1, 1.0) cm. Thereafter, pain scores did not differ significantly. Median total opioid (tramadol) consumption was 441 [QI, Q3: 280, 578] mg in the ondansetron group and 412 [309, 574] mg in the placebo group, P = 0.95. Conclusions: Ondansetron significantly decreased the analgesic effect of acetaminophen during the initial postoperative period. Our results thus confirm that acetaminophen analgesia is partially mediated by serotonin receptors. However, the reduction was of marginal clinical importance and short-lived. (C) 2017 Elsevier Inc. All rights reserved.

Description

Keywords

Anesthesia, Acetaminophen, Abdominal hysterectomy, Serotonergic pathway, Postoperative pain

Journal or Series

Journal of Clinical Anesthesia

WoS Q Value

Q3

Scopus Q Value

Q1

Volume

40

Issue

Citation