Drug | Dose[1] | Timing | Comments |
Adults | |||
Glucocorticoid | |||
Dexamethasone | IV: 4 to 8 mg | After induction of anesthesia | |
Serotonin (5-HT3) receptor antagonists | |||
Ondansetron | IV: 4 mg | IV: End of surgery | May prolong QT interval. ODT or oral soluble film may also be useful for PDNV. |
Oral: 8 mg (ODT or film) | Oral: 30 to 60 minutes prior to surgery | ||
Granisetron | IV: 0.35 to 3 mg | End of surgery | May prolong QT interval. |
Dolasetron* | IV: 12.5 mg | End of surgery | May prolong QT interval. |
Tropisetron* | IV: 2 mg | End of surgery | May prolong QT interval. |
Palonosetron | IV: 0.075 mg | At induction of anesthesia | |
Anticholinergic | |||
Scopolamine | Transdermal patch: 1.5 mg | Apply several hours (eg, ≥2 hours) before anesthesia | Remove 24 hours after surgery. |
Antidopaminergics | |||
Droperidol | IV: 0.625 to 1.25 mg | At the end of surgery | May prolong QT interval; per FDA recommendation, monitor ECG for 2 to 3 hours after administration. |
Haloperidol | IV, IM, oral: 1 mg | At the end of surgery | May prolong QT interval. |
Amisulpride | IV, prevention: 5 mg | Prevention: At induction of anesthesia | Administer over 1 to 2 minutes. May prolong QT interval. |
IV, treatment: 10 mg | |||
Neurokinin 1 receptor antagonists | |||
Aprepitant | Oral: 40 mg | Preoperative | May reduce efficacy of hormonal contraceptives. |
IV: 32 mg over 30 seconds | |||
Fosaprepitant | IV: 150 mg | Preoperative | May reduce efficacy of hormonal contraceptives. |
Rolapitant | Oral: 90 mg | Preoperative | Long half-life; useful for prevention of PDNV. |
Antihistamines | |||
Dimenhydrinate | IV: 1 mg/kg (maximum single dose: 100 mg) | Optimal timing not established | |
Diphenhydramine | IV: 1 mg/kg (maximum single dose: 100 mg) | Optimal timing not established | |
Children | |||
Glucocorticoid | |||
Dexamethasone | IV: 0.15 to 0.25[2] mg/kg (maximum dose: 4 mg) | After induction | |
Serotonin (5-HT3) receptor antagonists | |||
Ondansetron | IV: 0.1 mg/kg (maximum dose: 4 mg) | IV: End of surgery | May repeat dose for postoperative vomiting rescue; maximum total perioperative dose: 8 mg. ODT or oral soluble film may also be useful for PDNV[3]. |
Oral, children over 5 years of age[3]: 4 mg (ODT or film) | Oral: 30 to 60 minutes prior to surgery | ||
Granisetron | IV: 40 mcg/kg (maximum dose: 0.6 mg) | Optimal timing not established | QT prolongation has been observed in pediatric patients 2 to 16 years of age. |
Dolasetron* | IV: 0.35 mg/kg (maximum dose: 12.5 mg) | End of surgery | |
Antihistamines | |||
Dimenhydrinate | IV: 0.5 mg/kg IV (maximum dose: 25 mg) | Optimal timing not established | |
Diphenhydramine | IV: 0.5 mg/kg IV (maximum dose: 25 mg) | Optimal timing not established |
ECG: electrocardiogram; FDA: United States Food and Drug Administration; IM: intramuscular; IV: intravenous; ODT: orally disintegrating tablet; PDNV: post-discharge nausea and vomiting; PONV: postoperative nausea and vomiting.
* Not available in the United States.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟