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Tropisetron reduces postoperative vomiting in children undergoing tonsillectomy
A B Jensen1, D B Christiansen, K Coulthard
1Royal Danish School of Pharmacy, Universitetsparken 2, DK-2100, Copenhagen, Denmark.
Insights
Tropisetron effectively reduced postoperative vomiting in children undergoing tonsillectomy. This antiemetic significantly decreased vomiting incidence and frequency compared to placebo, with similar minor side-effect rates.
Area of Science:
- Pediatric Anesthesiology
- Pharmacology
- Surgical Outcomes
Background:
- Postoperative nausea and vomiting (PONV) are common complications in pediatric surgery.
- Tonsillectomy is associated with a high incidence of PONV.
- Effective antiemetic strategies are crucial for pediatric surgical care.
Purpose of the Study:
- To evaluate the efficacy and safety of intravenous tropisetron in preventing postoperative vomiting in children undergoing tonsillectomy.
- To compare tropisetron with placebo in a randomized, blinded study.
Main Methods:
- A double-blind, randomized, placebo-controlled trial was conducted.
- Pediatric patients undergoing tonsillectomy received either intravenous tropisetron (0.2 mg/kg up to 5 mg) or placebo at anesthesia induction.
- Vomiting episodes were recorded during the first 24 hours post-surgery.
Main Results:
- Intravenous tropisetron significantly reduced the incidence of vomiting from 89% in the placebo group to 46% (P<0.001).
- The mean number of vomits decreased from 4.6 to 2.4 in the tropisetron group compared to placebo (P<0.001).
- Minor side effects were comparable between the tropisetron and placebo groups.
Conclusions:
- Intravenous tropisetron is an effective and safe antiemetic for reducing postoperative vomiting in children undergoing tonsillectomy.
- Tropisetron offers a significant benefit in managing PONV in this pediatric surgical population.
Abstract:
In this patient, parent and investigator blinded, randomized, placebo-controlled study, children undergoing tonsillectomy (mean age 6.4 years) received either intravenous placebo (n=36) or tropisetron 0.2 mg.kg-1 up to 5 mg (n=35) at induction of anaesthesia with halothane, nitrous oxide and oxygen. Morphine and paracetamol were given in theatre for postoperative pain. Episodes of vomiting were recorded during the first 24 h after surgery. Intravenous tropisetron was significantly (P<0.001, chi-squared) more effective than placebo in controlling the incidence and frequency of emesis during the first 24 h: vomiting was reduced from 89% to 46% and the mean number of vomits from 4.6 to 2.4. Minor side-effects occurred equally in both the placebo and active groups. Intravenous tropisetron is an effective and safe antiemetic for reducing postoperative vomiting in children undergoing tonsillectomy or adenotonsillectomy.