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Caffeine for the prevention of postoperative nausea and vomiting

CONTEXT: Postoperative nausea and vomiting (PONV) is common after ambulatory surgery performed under general anesthesia. Anecdotal evidence suggests that caffeine may be useful in preventing PONV. AIMS: The aim of the study was to determine efficacy of intravenous (IV) caffeine given prior to surger...

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Detalles Bibliográficos
Autores principales: Steinbrook, Richard A, Garfield, Frances, Batista, Stacey H, Urman, Richard D
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3819849/
https://www.ncbi.nlm.nih.gov/pubmed/24249992
http://dx.doi.org/10.4103/0970-9185.119170
Descripción
Sumario:CONTEXT: Postoperative nausea and vomiting (PONV) is common after ambulatory surgery performed under general anesthesia. Anecdotal evidence suggests that caffeine may be useful in preventing PONV. AIMS: The aim of the study was to determine efficacy of intravenous (IV) caffeine given prior to surgery is effective prophylaxis against PONV. SETTINGS AND DESIGN: We conducted a prospective, randomized, double-blind, placebo-controlled study. SUBJECT AND METHODS: Patients at moderate or high risk of PONV were randomized to receive IV caffeine (500 mg) or saline placebo during general anesthesia; all patients received dexamethasone and dolasetron. STATISTICAL ANALYSIS: Statistical comparisons were tested using bivariable linear and logistic regression for each outcome and then adjusted for high/low risk. RESULTS: Nausea in the postanesthesia care unit (PACU) was more common in the caffeine (16 of 62 patients) than the placebo group (seven of 69; P = 0.02). There were no significant differences in the use of rescue antiemetics in the PACU, in the incidence of nausea or vomiting over 24 h postoperatively, nor in other outcomes (headache, fatigue, or overall satisfaction) either in the PACU or at 24 h; time-to-discharge was similar for both groups. CONCLUSION: Caffeine was not effective in the prevention of PONV or headache, and did not improve time-to-discharge or patient satisfaction.