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[Tropisetron for prevention of nausea and vomiting in children undergoing tonsillectomy and/or adenoidectomy]

C M Dillier1, M Weiss, A C Gerber

  • 1Anästhesieabteilung, Universitäts-Kinderklinik Zürich. claudia.dillier@kispi.unizh.ch

Der Anaesthesist
|June 7, 2000
PubMed

Insights

A single dose of tropisetron effectively prevented postoperative nausea and vomiting (PONV) in children undergoing tonsillectomy. This new 5HT3 receptor antagonist demonstrated safety and efficacy in pediatric surgical patients at high risk for PONV.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pharmacology

Background:

  • Postoperative nausea and vomiting (PONV) is a frequent complication in children after tonsillectomy.
  • Tropisetron, a 5HT3 receptor antagonist, has shown success in pediatric cancer therapy.
  • The study aimed to evaluate tropisetron for PONV prevention in at-risk pediatric surgical patients.

Purpose of the Study:

  • To assess the efficacy of a single intravenous tropisetron dose in preventing PONV in children undergoing tonsillectomy or adenotonsillectomy.
  • To evaluate the safety profile of tropisetron in this pediatric population.
  • To compare tropisetron's effectiveness against a placebo in reducing PONV incidence and severity.

Main Methods:

  • A randomized, double-blind, placebo-controlled trial involving 98 children aged 2-12 years.
  • Patients received either placebo or tropisetron (0.1 mg/kg) intravenously post-anesthesia induction.
  • Standard anesthetic techniques were employed, with monitoring of vital signs, sedation, and PONV episodes.

Main Results:

  • Tropisetron significantly reduced vomiting episodes (65.3% vs. 34.7%, p=0.0024).
  • Fewer patients in the tropisetron group experienced more than three vomiting episodes (10.2% vs. 22.4%, p=0.0004).
  • The need for antiemetic rescue medication was significantly lower in the tropisetron group (10.4% vs. 28.6%, p=0.025), with no significant adverse effects.

Conclusions:

  • A single prophylactic intravenous dose of tropisetron effectively reduces PONV incidence within 24 hours post-tonsillectomy/adenoidectomy.
  • Tropisetron is safe and justified for prophylactic use in pediatric surgical patients at high risk for PONV.
  • The study supports tropisetron as a valuable option for PONV management in pediatric surgery.
Abstract

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