Transdermal Scopolamine Patch with Odansetron for the Control of Nausea after Uterine Artery Embolization Compared with Odansetron Alone: Results of a Randomized Placebo–Controlled Trial

Abstract

To determine whether the transdermal scopolamine patch in combination with odansetron is more effective than odansetron alone at reducing the nausea that occurs after uterine artery embolization (UAE). Patients undergoing UAE at a single university medical center were randomly assigned to receive either a scopolamine patch (containing 1.5 mg of scopolamine) or a placebo. All participants and study personnel were blinded as to group assignment. The primary outcome was the degree of nausea in the first 24 hours after UAE as measured on a visual analog scale from 0 to 10. Nausea and pain at 24 and 72 hours after UAE and medication use were recorded. Baseline characteristics and outcomes were also analyzed. A total of 74 patients were enrolled; 37 were randomly assigned to receive scopolamine, and 37 received placebo. Although the overall level of nausea after UAE was low (mean score of 2.6 out of 10), there was a lower level of nausea with those treated with scopolamine compared with placebo during the first 24 hours after embolization; the difference was statistically significant (1.8 vs 3.4, P = .03). Adverse events were more common with the patch, with two patients experiencing episodes of profound disorientation and 71% reporting substantial dry mouth. The only predictor of greater nausea was the increasing severity of pain. The scopolamine patch provides a moderate reduction in the nausea associated with UAE but is associated with infrequent but notable episodes of patient disorientation.