Transdermal Scopolamine: An Alternative to Ondansetron and Droperidol for the Prevention of Postoperative and Postdischarge Emetic Symptoms

@article{White2007TransdermalSA,
  title={Transdermal Scopolamine: An Alternative to Ondansetron and Droperidol for the Prevention of Postoperative and Postdischarge Emetic Symptoms},
  author={Paul F. White and Jun Tang and Dajun Song and Jayne E. Coleman and Ronald H. Wender and Babatunde O. Ogunnaike and Alexander Sloninsky and Rajani Kapu and Mary Shah and Thomas Webb},
  journal={Anesthesia \& Analgesia},
  year={2007},
  volume={104},
  pages={92-96}
}
BACKGROUND:Given the controversy regarding the use of droperidol and the high cost of the 5-HT3 antagonists, a cost-effective alternative for routine use as a prophylactic antiemetic would be desirable. We designed two parallel, randomized, double-blind sham and placebo-controlled studies to compare the early and late antiemetic efficacy and adverse event profile of transdermal scopolamine (TDS) 1.5 mg, to ondansetron 4 mg IV, and droperidol 1.25 mg IV for antiemetic prophylaxis as part of a… 

Tables from this paper

Use of a Disposable Acupressure Device as Part of a Multimodal Antiemetic Strategy for Reducing Postoperative Nausea and Vomiting
TLDR
Use of the Pressure Right acupressure device in combination with antiemetic drugs provided a reduction in the incidence of vomiting from 0 to 72 hours after surgery with an associated improvement in patient satisfaction with their PONV management, but recovery and outcome variables failed to demonstrate any improvement with the addition of the acupressesure device.
The effect of transdermal scopolamine for the prevention of postoperative nausea and vomiting
TLDR
Transdermal scopolamine is a promising candidate for the management of PONV in adults as a first line monotherapy or in combination with other drugs and might be helpful in preventing postoperative discharge nausea and vomiting owing to its long-lasting clinical effects.
Effect of intravenous scopolamine before stapling, on postoperative nausea and vomiting in sleeve gastrectomy patients: a randomized controlled trial
TLDR
It is concluded that incidence of PONV in obese patients undergoing LSG is not affected by scopolamine, and further trials are needed to validate the results.
Revisiting transdermal scopolamine for postoperative nausea and vomiting
TLDR
Transdermal scopolamine is easy to administer, safe, effective, and relatively cost-effective, and it should be considered as an important tool to help prevent PONV/PDNV, whether administered as monotherapy or in combination with other agent(s).
Perspectives on transdermal scopolamine for the treatment of postoperative nausea and vomiting.
The effect of transdermal scopolamine plus intravenous dexamethasone for the prevention of postoperative nausea and vomiting in patients with epidural PCA after major orthopedic surgery
TLDR
The prophylactic use of a TDS patch plus dexamethasone was found to be a more effective means of preventing PONV in patients that received epidural PCA after major orthopedic surgery than dexamithasone alone or dexamETHasone plus ramosetron without adversely affecting side effects.
...
...

References

SHOWING 1-10 OF 15 REFERENCES
Double–blind comparison of transdermal scopolamine, droperidol and placebo against postoperative nausea and vomiting
TLDR
It is concluded that prophylactic transdermal scopolamine does not diminish postoperative emetic sequelae and its antiemetic effect with intravenous droperidol (DHBP), the authors' routine antidote for postoperativeEmesis.
Transdermal scopolamine reduces nausea and vomiting after outpatient laparoscopy.
TLDR
Transdermal scopolamine is a safe and effective antiemetic for outpatients undergoing laparoscopy in a double-blind, placebo-controlled study.
The Efficacy and Safety of Transdermal Scopolamine for the Prevention of Postoperative Nausea and Vomiting: A Quantitative Systematic Review
TLDR
The role of scopolamine administered via transdermal therapeutic systems in the prevention of postoperative vomiting, nausea, and nausea and vomiting is unclear and the timing of application does not alter efficacy.
Premedication with promethazine and transdermal scopolamine reduces the incidence of nausea and vomiting after intrathecal morphine
TLDR
The effect of different premedications on postoperative emetic sequelae induced by intrathecal morphine was studied in a prospective, double blind study of arthroplasty surgery of the lower extremity.
Increased incidence of retching and vomiting during periovulatory phase after middle ear surgery
TLDR
The incidence of R&V after middle ear surgery was lower during the perimenstrual phase and transdermal scopolamine was more efficient as prophylaxis against R& V than ondansetron in the periovulatory phase.
Effect of transdermal hyoscine on nausea and vomiting after surgical correction of prominent ears under general anaesthesia.
TLDR
In the placebo group more patients (48%) needed droperidol as an antiemetic compared with the hyoscine group (16%; P < 0.05), and there was significantly more sedation in the hyoscope group.
Transdermal Scopolamine in Motion Sickness
TLDR
A new system of drug delivery, the transdermal therapeutic system (TTS) — Transderm®‐V — has been developed, which permits a drug with a very short half life to be administered over prolonged periods, thereby maintaining blood concentrations at the defined therapeutic level.
A factorial trial of six interventions for the prevention of postoperative nausea and vomiting.
TLDR
Ondansetron, dexamethasone, and droperidol each reduced the risk of postoperative nausea and vomiting by about 26 percent, and the safest or least expensive antiemetic interventions should be used first.
Prevention of postoperative nausea and vomiting--a multimodal solution to a persistent problem.
  • P. White
  • Medicine
    The New England journal of medicine
  • 2004
Despite the introduction of new antiemetic agents, short-acting anesthetics, and minimally invasive surgical techniques, the incidence of postoperative nausea and vomiting has remained largely unch...
A Postanesthetic Recovery Score
TLDR
Ten years ago, Virginia Apgarl first proposed her new method of evaluation of neonates, which remains the simplest and perhaps most reliable manner to objectively describe the physical condition of the infant at birth.
...
...