Q: What is one off label use of  Ondansetron (Zofran) in Surgical ICUs beside management of  post-operative nausea and vomiting (PONV)?


Answer:  Post-op shivering

Zofran has been reported as effective as Demerol for post-op shivering  as a single intravenous dose 2 minutes before anesthesia. It can reduce shivering from 50 to 13.3% along with its good safety profile.



References:  

1. Generali JA, Cada DJ (August 2009). "Ondansetron: postanesthetic shivering" - Hospital Pharmacy 44 (8): 670–1.1. 

2. Kelsaka E, Baris S, karakoya D, Sarihasan B. Comparison of ondansetron and meperidine for prevention of shivering in patients undergoing spinal anesthesia. Reg Anesth Pain Med. 2006;31:40–5.

3. Powell RM, Buggy DJ. Ondansetron given before induction of anesthesia reduces shivering after general anesthesia. Anesth Analg. 2000;90:1423–7.