Ondansetron administration before transoesophageal echocardiography reduces the need for sedation and improves patient comfort during the procedure

AIMS: Transoesophageal echocardiography (TEE) is an uncomfortable procedure for the majority of patients. In the current double-blind randomized prospective study, we sought to assess whether ondansetron would improve patient comfort, reduce the need for sedation, and increase tolerance during TEE, and we compared ondansetron, metoclopramide, and placebo. METHODS AND RESULTS: One hundred and fifty-six patients who underwent TEE were randomized into three groups receiving ondansetron HCl, metoclopramide, or placebo. Data concerning additional doses of midazolam, procedural time, recovery time in the outpatient ward, blood pressure values, percutaneous arterial oxygen saturation values, side effects of the medications used, and patient discomfort via a visual analogue scale (VAS) were collected and analysed. The ondansetron group received less additional midazolam than the metoclopramide and placebo groups (ondansetron group: 0.6 ± 0.7 mg; metoclopramide group: 1.9 ± 0.9 mg; and placebo group: 2.1 ± 0.8 mg; P < 0,001). VAS was significantly lower in the ondansetron group than in the metoclopramide and placebo groups (4.0 ± 1.6, 6.1 ± 1.8, and 6.6 ± 1.6, respectively; P < 0.001). Recovery time in the outpatient ward was shorter in the ondansetron group than in the metoclopramide and placebo groups (22.5 ± 4.8, 30.9 ± 6.6, and 30.4 ± 5.0 min, respectively; P < 0.001). No adverse reaction to ondansetron was observed, whereas one patient developed mild spontaneously resolving dystonia due to metoclopramide. CONCLUSION: Ondansetron administration reduces the need for sedation during TEE and improves patient comfort.