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Prophylactic use of ondansetron for emesis after craniofacial operations in children

T Gürler1, N Celik, S Totan

  • 1Department of Plastic and Reconstructive Surgery, Ege University Medical School, Izmir, Turkey.

Insights

Children undergoing craniofacial surgery often experience postoperative nausea and vomiting. Prophylactic ondansetron significantly reduced vomiting episodes in pediatric patients, improving recovery outcomes.

Area of Science:

  • Pediatric Anesthesiology
  • Surgical Patient Care
  • Pharmacology

Background:

  • Craniofacial operations pose a high risk for postoperative nausea and vomiting (PONV) in children.
  • PONV can lead to delayed recovery, cerebrospinal fluid leaks, and fistula formation.
  • Ondansetron, a selective serotonin antagonist, shows efficacy in high-risk patient groups.

Purpose of the Study:

  • To evaluate the prophylactic efficacy of intravenous ondansetron in preventing PONV in pediatric patients undergoing craniofacial surgery.
  • To compare ondansetron's effectiveness against a placebo in this specific high-risk population.

Main Methods:

  • A randomized, double-blind, placebo-controlled study.
  • Participants received either intravenous ondansetron (0.15 mg/kg) or normal saline placebo at anesthesia induction.
  • A second dose was administered 8 hours post-induction; vomiting episodes were recorded over 48 hours.

Main Results:

  • Postoperative vomiting was significantly reduced in the ondansetron group compared to the placebo group (P = 0.000258).
  • Ondansetron demonstrated a clear preventative effect on vomiting episodes following craniofacial procedures.

Conclusions:

  • Intravenous ondansetron is effective in preventing postoperative vomiting in pediatric patients undergoing craniofacial operations.
  • Prophylactic ondansetron administration can mitigate a common complication, potentially improving patient outcomes and recovery.

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