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Effect of tropisetron on vomiting during patient-controlled analgesia in children
1Department of Anaesthesia, Princess Margaret Hospital for Children, Subiaco, Perth, Australia.
Insights
Tropisetron significantly reduces postoperative vomiting in children receiving patient-controlled analgesia (PCA). This antiemetic prevents nausea and vomiting, improving recovery after surgery.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Background:
- Postoperative nausea and vomiting (PONV) are common complications of patient-controlled analgesia (PCA).
- Tropisetron, a 5-HT3 receptor antagonist, is effective for chemotherapy-induced nausea and vomiting and PCA-associated nausea and vomiting in adults.
- Effective PONV prophylaxis is crucial for pediatric postoperative recovery.
Purpose of the Study:
- To evaluate the efficacy of prophylactic intraoperative tropisetron in preventing vomiting in children undergoing PCA.
- To assess the impact of tropisetron on the incidence and severity of vomiting in pediatric PCA patients.
Main Methods:
- A randomized controlled trial involving 58 pediatric patients using morphine PCA.
- Patients received either tropisetron (0.1 mg kg-1, max 5 mg) or normal saline intraoperatively.
- Vomiting incidence and severity were recorded within 24 hours postoperatively.
Main Results:
- The tropisetron group showed a significantly lower incidence of vomiting (22%) compared to the control group (66%) (P = 0.001).
- Vomiting severity was also reduced, with only 4% in the tropisetron group experiencing more than two episodes versus 31% in the control group (P = 0.01).
Conclusions:
- Prophylactic intraoperative tropisetron is effective in reducing the incidence and severity of postoperative vomiting in children using PCA.
- Tropisetron administration improves postoperative recovery by mitigating PONV in pediatric PCA patients.
Abstract:
Patient-controlled analgesia (PCA) is associated with a high incidence of vomiting which is distressing and interferes with postoperative recovery. Tropisetron, a long-acting selective 5-HT3 receptor antagonist, has been shown to be effective in preventing nausea and vomiting associated with PCA use in adults and chemotherapy in children. We assessed the efficacy of prophylactic intraoperative administration of tropisetron on the incidence of vomiting in children using morphine PCA. We studied 58 patients, allocated randomly to receive tropisetron 0.1 mg kg-1 to a maximum of 5 mg, or normal saline. Children who received tropisetron had an incidence of vomiting during the first 24 h after operation of 22% compared with 66% in the control group (P = 0.001). In addition, the severity of vomiting was less in the tropisetron group with only one child (4%) vomiting more than twice compared with nine (31%) in the control group (P = 0.01). We conclude that tropisetron is efficacious in reducing the incidence and severity of postoperative vomiting in children using PCA.