ondansetron (Zuplenz / ondansetron OFDS)

Oliceridine vs Sufentanil Combined With Ondansetron for Postoperative Nausea and Vomiting and QTc Interval in Hysteroscopic Surgery: A Prospective Randomized Controlled Study.

Guo Zhijia Z, Wu Yanan Y, Sang Yuqian Y

BACKGROUND Postoperative nausea and vomiting (PONV) is common after hysteroscopic surgery, and opioid use can raise concerns regarding cardiac safety. This prospective study aimed to compare the effects of oliceridine plus ondansetron versus sufentanil plus ondansetron on 24-hour PONV incidence and perioperative changes in the corrected QT interval (QTc) in patients undergoing non-intubated hysteroscopy under general anesthesia. MATERIAL AND METHODS In this randomized, double-blind, controlled study, 62 patients undergoing hysteroscopic surgery under general anesthesia were analyzed. Patients received propofol 2 mg/kg with either oliceridine 0.039 mg/kg plus ondansetron 4 mg (O group) or sufentanil 0.1 μg/kg plus ondansetron 4 mg (S group). The primary endpoint was 24-hour PONV. Secondary endpoints included emergence time, post-anesthesia care unit (PACU) pain scores, and change in QTc from baseline (ΔQTc) measured by 5-lead electrocardiography at predefined time points. RESULTS PONV incidence within 24 h did not differ significantly between groups (0% vs 3.2%, P>0.05). Time to anesthesia emergence was comparable between groups (P=0.960). Numerical rating scale scores at PACU discharge were also comparable (P=0.186). Repeated-measures ANOVA showed a significant time effect for ΔQTc (P=0.001), but no significant group effect (P=0.076) or group×time interaction (P=0.171). CONCLUSIONS Oliceridine plus ondansetron did not significantly reduce 24-hour PONV compared with sufentanil plus ondansetron, and this finding should be interpreted cautiously because of limited statistical power. Perioperative ΔQTc changes were minimal and similar between groups, with no clinically significant QTc prolongation.

Retraction Note to: Repeated Forced Swim Exacerbates Methamphetamine-Induced Neurotoxicity: Neuroprotective Effects of Nanowired Delivery of 5-HT3-Receptor Antagonist Ondansetron.

Lafuente José Vicente JV, Sharma Aruna A, Muresanu Dafin F DF, Ozkizilcik Asya A et al.

Risk factors for postoperative nausea and vomiting after sleeve gastrectomy and the impact of intraoperative ondansetron: a retrospective cohort study.

Dobruchowska-Kęsikowska Eliza E, Wityk Mateusz M, Mysiorska Dominika D, Młyńska Julia J et al.

Postoperative nausea and vomiting (PONV) remain common adverse postoperative events after sleeve gastrectomy (SG), and they may negatively affect patient recovery. The aim of this study was to identify risk factors for PONV after SG and to evaluate the impact of intraoperative ondansetron administration on both the occurrence and severity of PONV. A retrospective analysis of patients who underwent primary SG between 2024 and 2025 in a single bariatric center was conducted. Since PONV episodes were not recorded directly, the symptoms were assessed indirectly based on antiemetic consumption. Any PONV was defined as administration of at least 8 mg of ondansetron within 24 hours after surgery, whereas severe PONV was defined as a requirement for 16 mg of ondansetron or more with or without additional antiemetic agents. A total of 463 patients were included. Any PONV occurred in 195 patients (42.1%), while severe PONV was observed in 57 individuals (12.3%). Male sex (odds ratio [OR], 0.36; 95% CI, 0.22-0.61; P <0.001), older age (OR, 0.97; 95% CI, 0.95-0.99; P = 0.01), elevated body mass index (OR, 0.96; 95% CI, 0.93-1; P = 0.03), hypertension (OR, 0.53; 95% CI, 0.33-0.83; P = 0.006), and intraoperative ondansetron administration (OR, 0.38; 95% CI, 0.24-0.58; P <0.001) were independently associated with a lower risk of any PONV. Male sex was an independent protective factor against severe PONV (OR, 0.11; 95% CI, 0.03-0.48; P = 0.003). Intraoperative ondansetron administration was associated with a lower risk of PONV after SG. Male sex was the only independent protective factor against severe PONV, while ondansetron showed no significant effect on the occurrence of severe symptoms.

Comparative Effectiveness of Haloperidol, Droperidol, and Ondansetron for Cannabinoid Hyperemesis Syndrome in the Emergency Department.

O'Brien Joseph J, Patel Mayher M, Brown Joseph J, Tucker Ryan R et al.

Cannabinoid hyperemesis syndrome (CHS) is an increasingly frequent emergency department (ED) presentation. Although ondansetron is commonly used, emerging evidence suggests haloperidol and droperidol may provide more effective symptom control. Robust comparative effectiveness data, particularly regarding short-term ED recidivism, remain limited. We conducted a multicenter retrospective cohort study using the TriNetX Research Network from 2014 to 2024. Adults presenting to the ED with vomiting-related and cannabis-related ICD-10 diagnoses who received haloperidol, droperidol, or ondansetron during the index encounter were included. Patients with alternative causes of vomiting or major confounding conditions were excluded. Propensity-score matching was performed for three pairwise comparisons: haloperidol versus ondansetron, droperidol versus ondansetron, and droperidol versus haloperidol. The primary outcome was 72-h ED recidivism. Secondary outcomes included 72-h hospital admission, 7-day ED recidivism, and coded adverse events. Multivariable Cox proportional hazards modeling evaluated independent predictors of 72-h ED recidivism. After matching, haloperidol was associated with lower 72-h ED recidivism compared with ondansetron (8.2% vs. 15.1%; OR 0.50, 95% CI 0.41-0.62; p < 0.0001). Droperidol was also associated with lower 72-h ED recidivism compared with ondansetron (7.4% vs. 14.0%; OR 0.49, 95% CI 0.32-0.76; p = 0.0014). Droperidol and haloperidol did not differ significantly in 72-h ED recidivism (7.5% vs. 9.8%; OR 0.75, 95% CI 0.47-1.20; p = 0.23). In the multivariable model, haloperidol (HR 0.62, 95% CI 0.49-0.79) and droperidol (HR 0.68, 95% CI 0.56-0.83) were independently associated with lower return risk, whereas ondansetron was not. Coded adverse events were rare across all groups. In this large multicenter cohort, haloperidol and droperidol were associated with lower short-term ED recidivism than ondansetron among adults meeting a suspected CHS phenotype. These findings support prospective studies evaluating haloperidol and droperidol for ED management of CHS, including optimal dosing, route, medication sequencing, discharge treatment, and safety monitoring.