Oral mosapride can provide additional anti-emetic efficacy following total joint arthroplasty under general anesthesia:
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RESEARCH ARTICLE
Open Access
Oral mosapride can provide additional antiemetic efficacy following total joint arthroplasty under general anesthesia: a randomized, double-blinded clinical trial Jinwei Xie1, Yingchun Cai1,2, Jun Ma1, Qiang Huang1 and Fuxing Pei1*
Abstract Background: We sought to determine (1) whether the addition of prophylactic oral mosapride to a protocol including dexamethasone and ondansetron further reduces postoperative nausea and vomiting (PONV) compared with ondansetron alone or the combination of both; (2) whether preemptive application of oral mosapride provides additional clinical benefits for bowel function and appetite, thus improving functional recovery. Methods: We randomized 240 patients undergoing total hip and knee arthroplasty to receive placebo (Control, n = 80), dexamethasone (10 mg) before anesthesia induction (Dexa, n = 82), or dexamethasone (10 mg) before anesthesia induction as well as oral mosapride (5 mg) before and after surgery (Mosa+Dexa, n = 78). Patients were assessed at 0–6, 6–12, 12–24, and 24–48 h postoperatively. Primary outcomes were incidence and severity of PONV as well as complete response. Secondary outcomes were appetite, time until first defecation and ambulation, patient satisfaction score, and length of hospital stay. Results: Mosa+Dexa patients showed significantly lower incidence of nausea at 6–12 h (3.8%) and over the entire evaluation period (6.4%), as well as a higher rate of complete response (89.7%) than other patients. Mosa+Dexa patients required less time to achieve first defecation and ambulation, they were hospitalized for shorter time, and they were more satisfied with clinical care. Conclusion: Addition of oral mosapride further reduced incidence of PONV, especially postoperative nausea, during 6–12 h postoperatively. Moreover, preemptive application of oral mosapride can further improve appetite, bowel function, ambulation and length of hospital stay. Trial registration: The study protocol was registered at the Chinese Clinical Trial Registry (ChiCTR1800015896), prospectively registered on 27/04/2018. Keywords: PONV, Total joint arthroplasty, General anesthesia, Bowel function
* Correspondence: [email protected] 1 Department of Orthopaedic Surgery, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan Province 610041, People’s Republic of China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. I
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