Date of Award

2015

Degree Name

Management Practice in Nurse Anesthesia

College

Graduate College

Type of Degree

DMPNA

Document Type

Research Paper

First Advisor

Alberto Coustasse, Committee Chair, Lewis College of Business, Marshall University

Second Advisor

Kathryn Newcome, Committee Member, Charleston Area Medical Center School of Nurse Anesthesia

Third Advisor

Kristen Spurgeon, Committee Member, Charleston Area Medical Center General Hospital

Abstract

Introduction: Post-Operative Nausea and Vomiting (PONV) is a recurrent and frequent issue for the patient, the anesthesia team, and Post Anesthesia Care Unit (PACU) team. Both pharmacologic and non-pharmacologic recommended modalities have been utilized for both the prevention and treatment of PONV in the surgical-anesthesia setting. The 5-HT3-receptor antagonist ondansetron is one of the many known pharmacological modalities commonly utilized by anesthesia providers in preventing PONV.

Methodology: The design used for this research was a quantitative, retrospective case control study that evaluated existing data enclosed in the Electronic Medical Records (EMR) from Charleston Area Medical Center (CAMC), which is made up of four hospitals. The sample population included 89 patients: 64 patients with a BMI ³ 30kg/m2 who have received ondansetron 4 milligrams (mgs) and 25 patients with a BMI ³ 30kg/m2 who have received ondansetron 8 mgs. In this sample population, all of the patients were 18 to 64 years of age with an American Society of Anesthesiologist (ASA) I-IV undergoing mastectomy.

Results: There were no statistical significance found between the ondansetron dosage and the occurrence of PONV. There were no statistical significance found between the two groups and BMI (p >.05). The mean BMI for ondansetron 4 mgs group was 37 kg/m2 and ondansetron 8 mgs group was also 37 kg/m2. The mean dose of rescue antiemetic received in the PACU also did not show to be statistically significant between the two groups (p >.05).

Discussion: Approximately 19% of the patients in this study experienced PONV despite the intra-operative administration of ondansetron. There were no statistical significance that was found between the ondansetron dosing and PONV. This may be the result that the dosing of ondansetron may truly not make a difference in preventing PONV.

Conclusion: The outcome of this study did not express any statistically significant difference in the 4 mgs and 8 mgs dosing of ondansetron and the occurrence of PONV or the amount of rescue anti-emetic received in PACU.

Practical Implications: The result of this study did not demonstrate any additional benefit from a larger dose of 8 mgs compared to a dose of 4 mgs of ondansetron. Dosing 4 mgs may just be as effective as 8 mgs, which simply brings to light that more is not simply better in all cases. Further research is needed on this topic.

Subject(s)

Anesthesia -- Research.

Anesthesiology -- Research.

Additional Files
arryoy-deigo-2015-pt2.pptx (537 kB)
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