The Efficacy of Prophylactic Transdermal Scopolamine Versus Intravenous Ondansetron on Post Operative Nausea and Vomitting in Patients Undergoing Outpatient Laparoscopic Gynecological Procedures

Abstract

Postoperative nausea and vomiting is a frequent side effect experienced by patients who have undergone anesthesis. Although years of extensive research have been conducted on prevention and treatment of PONV, there is still an ongoing search for the perfect solution. Experiencing PONV can lead to a multitude of complications, including: decreased patient satisfaction, increased chance of morbidity, increased cost to the patient and hospital, increased workload on recovery staff, and increased length of hospital stay. It is necessary for health care practitioners to be aware of costs and ways to decrease them, avoiding the postoperative complication while utilizing less expensive medications is one mechanism of decreasing the overall cost of providing patient care. The treatment of PONV contains a multitude of options; however, current research indicates the new 5HT-3 receptor antagonists are the most effective treatment choice. Unfortunately, the most effective treatment is currently the most costly option. Research is needed to examine the use of less expensive options, versus the new gold standards, to determine the best choices in the treatment of PONV. The purpose of this study is to examine the effectiveness of transdermal scopolamine versus ondansetron in the treatment of PONV since scopolamine is significantly cheaper that the newer drug, ondansetron. When determining the "best" available option there is a multitude of factors to consider. These factors include: efficacy, cost, detrimental side effects, benefits, and the safety of the drug. It is the intent of this study to show that scopolamine has equal effectiveness in decreasing the occurrence of PONV with a significant decrease in cost. we also anticipate a decrease in the incidence of intraoperative bradycardia, pre-operative anxiety, and secretions, with the added benefit of a longer duration of action. These added benefits will thereby make scopolamine a safer, less expensive, and equally as effective alternative to the new 5 HT-3 receptor antagonists.