NDLI: Dose-ranging effect of systemic diphenhydramine on postoperative quality of recovery after ambulatory laparoscopic surgery: a randomized, placebo-controlled, double-blinded, clinical trial.

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Dose-ranging effect of systemic diphenhydramine on postoperative quality of recovery after ambulatory laparoscopic surgery: a randomized, placebo-controlled, double-blinded, clinical trial.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	De Oliveira, Gildasio S. Bialek, Jane Marcus, R-J McCarthy, Robert
Description	Author Affiliation: De Oliveira GS ( Department of Anesthesiology, Feinberg School of Medicine, Northwestern University. Electronic address: g-jr@northwestern.edu.); Bialek J ( Department of Anesthesiology, Feinberg School of Medicine, Northwestern University.); Marcus RJ ( Department of Anesthesiology, Feinberg School of Medicine, Northwestern University.); McCarthy R ( Department of Anesthesiology, Feinberg School of Medicine, Northwestern University.)
Abstract	STUDY OBJECTIVE: Diphenhydramine is an antihistamine with previously demonstrated analgesic and antiemetic properties. However, it is unknown if the beneficial perioperative properties of diphenhydramine can translate to a better quality of postsurgical recovery. The main objective of the current investigation was to investigate dose-ranging effects of diphenhydramine on quality of recovery after surgery. SETTING: Tertiary hospital in the United States. DESIGN: A prospective, randomized, double-blind trial. INTERVENTION: Saline, diphenhydramine 25 >mg, or diphenhydramine 50 mg given intravenously before induction. MEASUREMENTS: The primary outcome was global Quality of Recovery-40 at 24hours. Postoperative pain, nausea, opioid consumption, and discharge time were also evaluated. MAIN RESULTS: Ninety subjects were randomized, and 75 completed the study. The median (interquartile range) Quality of Recovery-40 scores were not different among study groups: 164 (151-189), 169 (159-181), and 172 (157-185) for the saline, 25-mg diphenhydramine, and 50-mg diphenhydramine groups, respectively (P=.74). Postoperative nausea was decreased in the 50-mg group, 3 of 24 (12.5%), compared with the saline group, 12 of 27 (44%), P=.01. There was an inverse linear association between postoperative opioid consumption and quality of recovery (R(2)=0.37, P<.001). CONCLUSIONS: Diphenhydramine does not provide dose-ranging improvements on postoperative quality of recovery after ambulatory laparoscopic gynecologic surgery. Our results support a recent concept that not all postoperative nausea and vomiting symptoms are clinically important. Future studies evaluating postoperative nausea and vomiting should include patient-centered outcomes to validate the clinical importance of the examined interventions.
File Format	HTM / HTML
ISSN	09528180
Journal	Journal of Clinical Anesthesia
Volume Number	34
e-ISSN	18734529
Language	English
Publisher	Elsevier
Publisher Date	2016-11-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Anesthesiology
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine

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