Effect of Transdermal Scopolamine for the Prevention of Postoperative Nausea and Vomiting Associated with Robotic Gynecologic Surgery: A Randomized, Double-Blinded, Placebo-Controlled Trial

Daniel Lee, Todd Tillmanns, Michael Ulm, Adam Mabe, Saurabh Kumar, Adam C. Elnaggar

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate the efficacy of transdermal scopolamine for treatment of postoperative nausea and vomiting (PONV) after robotic-assisted gynecologic surgery. Design: Prospective, randomized, double-blinded, placebo-controlled clinical trial. Method: Overall, 47 patients underwent robotic-assisted gynecologic surgery at two tertiary care hospitals, and they were randomized to receive transdermal scopolamine or placebo preoperatively. They then completed a series of questionnaires utilizing a visual analogue scale to rate their nausea and vomiting. Main outcomes were severity of nausea and vomiting till 72 hours postoperatively. Secondary outcomes were antiemetic use, time to discharge, effect on patient well-being of PONV, and patient overall well-being. Results: There was a benefit to the number of rescue antiemetics administered in the immediate postoperative period (0.30 vs. 0.70, p=0.026), but no significant reduction in incidence or severity of PONV, no overall decrease in amount of antiemetics used, no change in length of hospital stay, and no impact on patient well-being with use of scopolamine. Conclusion: Rates of PONV in this robotic population of patients using multi-modality therapy are less than 40%. Further studies are needed to investigate the use of transdermal scopolamine for prevention of PONV after robotic-assisted gynecologic surgery, as the only significant benefit of its use compared with placebo was a reduction in the number of rescue antiemetics administered in the first 6 hours postoperatively.

Original languageEnglish (US)
Pages (from-to)266-271
Number of pages6
JournalJournal of Gynecologic Surgery
Volume31
Issue number5
DOIs
StatePublished - Oct 1 2015

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Postoperative Nausea and Vomiting
Gynecologic Surgical Procedures
Scopolamine Hydrobromide
Robotics
Antiemetics
Placebos
Nausea
Vomiting
Length of Stay
Controlled Clinical Trials
Tertiary Healthcare
Visual Analog Scale
Postoperative Period
Tertiary Care Centers
Incidence
Therapeutics
Population

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology
  • Surgery

Cite this

Effect of Transdermal Scopolamine for the Prevention of Postoperative Nausea and Vomiting Associated with Robotic Gynecologic Surgery : A Randomized, Double-Blinded, Placebo-Controlled Trial. / Lee, Daniel; Tillmanns, Todd; Ulm, Michael; Mabe, Adam; Kumar, Saurabh; Elnaggar, Adam C.

In: Journal of Gynecologic Surgery, Vol. 31, No. 5, 01.10.2015, p. 266-271.

Research output: Contribution to journalArticle

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abstract = "Objective: To evaluate the efficacy of transdermal scopolamine for treatment of postoperative nausea and vomiting (PONV) after robotic-assisted gynecologic surgery. Design: Prospective, randomized, double-blinded, placebo-controlled clinical trial. Method: Overall, 47 patients underwent robotic-assisted gynecologic surgery at two tertiary care hospitals, and they were randomized to receive transdermal scopolamine or placebo preoperatively. They then completed a series of questionnaires utilizing a visual analogue scale to rate their nausea and vomiting. Main outcomes were severity of nausea and vomiting till 72 hours postoperatively. Secondary outcomes were antiemetic use, time to discharge, effect on patient well-being of PONV, and patient overall well-being. Results: There was a benefit to the number of rescue antiemetics administered in the immediate postoperative period (0.30 vs. 0.70, p=0.026), but no significant reduction in incidence or severity of PONV, no overall decrease in amount of antiemetics used, no change in length of hospital stay, and no impact on patient well-being with use of scopolamine. Conclusion: Rates of PONV in this robotic population of patients using multi-modality therapy are less than 40{\%}. Further studies are needed to investigate the use of transdermal scopolamine for prevention of PONV after robotic-assisted gynecologic surgery, as the only significant benefit of its use compared with placebo was a reduction in the number of rescue antiemetics administered in the first 6 hours postoperatively.",
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