Effect of transdermal hyoscine on nausea and vomiting during and after middle ear surgery under local anaesthesia.

The efficacy of transdermal hyoscine in the reduction of nausea, retching and vomiting was compared with placebo during and after stapedo- and tympanoplasty under local anaesthesia in a double-blind, prospective and randomized study. In the placebo group (n = 29), 69% of the patients were free from emetic symptoms during and 41% after the operation. The corresponding figures were 93% (P < 0.05) and 74% (P < 0.05) in the hyoscine group (n = 27). The patients in the placebo group needed more droperidol during and after operation (P < 0.05). The frequency of side effects was similar in both groups. In posturography the patients with emetic sequelae in the placebo group had a markedly deteriorated upkeep of posture (P < 0.05) measured as body sway velocities. A strong correlation was found between motion sickness and emetic sequelae after surgery, and patients with a history of motion sickness benefited most from hyoscine.