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Use of ondansetron to reduce gag reflex during intubation
by Marc Colbeck. Last modified: 30/06/14
Kaviani, N., & Ranjbaran, F. (2011). Evaluation of the efficacy of oral ondansetron on gag reflex in soft palate and palatine tonsil areas. Journal of Isfahan Dental School, 6(6), 691–697.
Here’s an interesting study I stumbled across at http://emcrit.org/blogpost/ondanestron-for-awake-intubation/. The original is in (I believe) Arabic, but the abstract is interesting enough in itself. It’s a study done by Dentists in the Middle East using placebo vs. ondansetron to test if ondansetron administration resulted in a decreased gag reflex; apparently it does. This would make it a useful adjunct to intubation in an awake patient. The original article is available here: http://jids.mui.ac.ir/index.php/jids/article/viewFile/240/1349
More information about IV ondansetron is available from this (always excellent) New Zealand government site: http://www.medsafe.govt.nz/profs/Datasheet/o/ondansetronclarisinj.pdf
Abstract
Introduction
Severe gagging in some patients during dental procedures can complicate the procedure. In this study, the effect of oral ondansetron and placebo, as antiemetic medications, on gag reflex was evaluated with the stimulation of soft palate and palatine tonsil areas to simulate the clinical situation during dental procedures.
Materials and methods
In this clinical trial, 88 healthy adult individuals were randomly divided into two equal groups of ondansetron and placebo, which were administered orally. Gag reflexes were checked using a tongue depressor and recorded before and 90 minutes after intervention in the soft palate and palatine tonsil areas. Data was analyzed and compared with SPSS software, using Mann-Whitney and Wilcoxon tests (α = 0.05).
Results
In the ondansetron group a statistically significant decrease in gag reflex was noted after intervention in both soft palate and tonsil areas (p value < 0.05); however, no significant decrease was observed in the placebo group in the two areas after intervention.
Conclusion
The results of the present study showed the efficacy of ondansetron in reducing the severity of gag reflex in both the soft palate and tonsil areas; therefore, its administration can be considered in clinical procedures in those areas.
Bottom line, it may be useful to administer ondansetron IV before attempting awake intubation in order to reduce the gag reflex.
The following two tabs change content below.Marc Colbeck
Senior Lecturer at Australian Catholic UniversityMarc is a Canadian Critical Care Paramedic with 14 years of clinical experience who has been working as a professional educator since the early 2000's. He has taught at the College and University level in the Middle East and Australia, and worked as the General Manager of Clinical Governance for an Australian State Ambulance Service. He is currently a Senior Lecturer at Australian Catholic University in Queensland, Australia. His undergraduate degree is in PreHospital Care and his MA is in Counseling Psychology. He is currently working on a PhD in Translational Health Sciences with the Joanna Briggs Institute at the University of Adelaide, with a special interest in the development and maintenance of paramedic CPGs. His website is www.marccolbeck.info.Latest posts by Marc Colbeck (see all)
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Use of ondansetron to reduce gag reflex during intubation
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