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Prevention of vomiting after strabismus surgery in children: dexamethasone alone versus dexamethasone plus low-dose

W M Splinter1

  • 1Department of Anaesthesia, Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Canada. splinter@cheo.on.ca

Paediatric Anaesthesia
|November 7, 2001
PubMed

Insights

Combining dexamethasone with ondansetron significantly reduced postoperative vomiting in children after strabismus surgery. This combination therapy proved more effective than dexamethasone alone in preventing vomiting episodes.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pharmacology

Background:

  • Postoperative vomiting is a frequent complication following strabismus surgery in children.
  • Dexamethasone alone has shown efficacy in reducing vomiting after tonsillectomy.
  • The combination of dexamethasone and ondansetron is known to decrease vomiting after strabismus surgery.

Purpose of the Study:

  • To compare the efficacy of dexamethasone alone versus a combination of ondansetron and dexamethasone in preventing postoperative vomiting in children undergoing strabismus surgery.

Main Methods:

  • A randomized, double-blind study involving 193 healthy children (aged 2-14 years) undergoing strabismus surgery.
  • Patients received either dexamethasone alone (Group D) or dexamethasone plus ondansetron (Group OD) intravenously.
  • Standardized anesthesia, fluid, and pain management protocols were followed, with patients monitored for 24 hours postoperatively.

Main Results:

  • The incidence of postoperative vomiting was significantly lower in the ondansetron plus dexamethasone group (5%) compared to the dexamethasone alone group (23%) (P < 0.001).
  • Each episode of vomiting was associated with a 29-minute increase in in-hospital length of stay (P < 0.001).

Conclusions:

  • The combination of dexamethasone and a low dose of ondansetron is highly effective in reducing postoperative vomiting after strabismus surgery in children.
  • This combination therapy offers a superior antiemetic effect compared to dexamethasone monotherapy in this pediatric surgical population.
Abstract

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