Post Anesthesia Care Unit Antiemetic Pilot Study

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Post Anesthesia Care Unit Antiemetic Pilot Study

• MAJ Laura L. Feider BSN, RN, CCRN, MN and CPT
  James A. Nolte BSN, RN, FNP, MSN
• Tripler Army Medical Center

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Purpose

• To validate the efficacy of Anzemet, compared to
  Zofran, as a cost-effective therapy in the
  prevention of postoperative nausea and vomiting.
• Hypothesis Patients who received Anzemet would
  not require further antiemetic interventions for
  postoperative nausea and vomiting during the
  recovery period.

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Background

• Postoperative nausea and vomiting is the most
  common side effect
• Zofran, a selective 5HT3 receptor antagonist is
  the first line antiemetic in the OR
• Anzemet, also a 5HT3 receptor antagonist is 1/3
  the cost of Zofran
• Previous studies only compared Anzemet to Zofran
  in oncology patient trials

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Methods

• Pilot study conducted in a 256 bed teaching
  hospital in 1999
• Average number of OR cases per month was
  approximately 500
• A descriptive data collection tool was developed
• Primary outcome was to prevent and control
  postoperative nausea and vomiting

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Data Collection Tool
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Methods

• All patients received an antiemetic by anesthesia
  providers preference in the OR
• Patient consent was not obtained, as there was
  no deviation from the standard of care by
  anesthesia providers
• Descriptive analysis of the data

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Picture of Anzemet and Zofran Vials
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Results (N 60)

• Demographics
• 23 males
• 37 females
• Anesthesia Type
• 57 general
• 2 general epidural
• 1 spinal

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Results

• 70 of patients receiving Anzemet reported no N
  V postoperatively
• _____ of patients receiving Zofran reported no N
  V
• Literature demonstrates only a 51 average of
  all antiemetics to prevent and control N/V
  postoperatively

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Conclusions

• Anzemet, compared to Zofran, is a logical and
  cost effective way to manage postoperative nausea
  and vomiting
• Cost savings to the hospital was 27,000
• Further study is needed to confirm these pilot
  study results

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Implications for Nursing Practice

• Staff nurses in the PACU provided evidence based
  research that a similar 5HT3 receptor antagonist
  antiemetic, in postoperative patients, Azemet, is
  effective in preventing and controlling
  postoperative nausea and vomiting
• In addition, cost savings and decreasing LOS due
  to postoperative nausea and vomiting were also of
  clinical significance

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