The Incidence of Torsades de Pointes With Perioperative Triple Antiemetic Administration.

IF 2.3 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Annals of Pharmacotherapy Pub Date : 2024-09-01 Epub Date: 2023-12-06 DOI:10.1177/10600280231215786
Gregory A Nuttall, Alyssa M Reed, Khue D Pham Louis, Lance J Oyen, Samuel P Marsland, Michael J Ackerman
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引用次数: 0

Abstract

Background: The safety of triple antiemetic therapy consisting of ondansetron, haloperidol, and a steroid, to surgical patients is unknown.

Objective: To determine the incidence of torsade de pointes (TdP) or death following perioperative administration of triple antiemetic therapy.

Methods: A retrospective cohort study identified 19,874 patients who received 22,202 doses of triple antiemetics during the 2.5-year time frame from March 4, 2020 to September 7, 2022 for surgical nausea prophylaxis or treatment of nausea. These patients above were cross-matched with an electrocardiogram and adverse outcome database; this identified 226 patients with documentation of a QTc > 450 ms, all ventricular tachycardias including TdP within 48 hours of receiving triple antiemetic therapy, or death within 7 days of receiving ondansetron.

Results: There were 3 patients who had documented VT (n = 3), but there were no documented incidents of TdP (n = 0). There were 9 codes called on patients within 48 hours of medication administration, and none of them were due to ventricular arrythmias (n = 0). A total of 11 patients died within 7 days of triple antiemetic therapy. Ten of the 11 deaths were determined to not be from the triple antiemetic. One patient died at home within 24 hours of the procedure of an unknown cause (n = 1).

Conclusions and relevance: No episodes of TdP were identified in patients receiving triple antiemetic therapy perioperatively, though the cause of death in 1 patient could not be determined. This suggest that low-dose triple antiemetic therapy is low risk for the development of TdP.

围术期服用三联止吐药导致的 Torsades de Pointes 发生率
背景:手术患者接受由昂丹司琼、氟哌啶醇和类固醇组成的三联止吐疗法的安全性尚不清楚:目的:确定围手术期使用三联止吐疗法后发生心搏骤停(TdP)或死亡的几率:一项回顾性队列研究发现,在 2020 年 3 月 4 日至 2022 年 9 月 7 日的 2.5 年时间内,有 19,874 名患者因手术恶心预防或治疗而接受了 22,202 剂三联止吐药。将上述患者与心电图和不良反应数据库进行交叉比对;结果发现,有 226 名患者在接受三联止吐药治疗后 48 小时内出现 QTc > 450 毫秒、包括 TdP 在内的所有室性心动过速,或在接受昂丹司琼治疗后 7 天内死亡:有记录的室性心动过速患者有 3 名(n = 3),但没有记录的 TdP 事件(n = 0)。在用药后 48 小时内,有 9 名患者被叫到代码,但无一例是由于室性心律失常(n = 0)。共有 11 名患者在接受三联止吐疗法 7 天内死亡。在这11例死亡病例中,有10例被确定并非死于三联止吐药。一名患者在手术后24小时内死于家中,死因不明(1例):在围手术期接受三联止吐疗法的患者中未发现TdP发作,但有一名患者的死因无法确定。这表明小剂量三联止吐疗法发生TdP的风险较低。
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来源期刊
CiteScore
5.70
自引率
0.00%
发文量
166
审稿时长
3-8 weeks
期刊介绍: Annals of Pharmacotherapy (AOP) is a peer-reviewed journal that advances pharmacotherapy throughout the world by publishing high-quality research and review articles to achieve the most desired health outcomes.The articles provide cutting-edge information about the most efficient, safe and cost-effective pharmacotherapy for the treatment and prevention of various illnesses. This journal is a member of the Committee on Publication Ethics (COPE). Average time from submission to first decision: 14 days
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