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Motion sickness and postoperative vomiting in children
Paolo Busoni1, Armando Sarti, Massimo Crescioli
1Ospedale Pediatrico 'A. Meyer', Firenze, Firenze, Italy. p.busoni@ao-meyer.toscana.it
Insights
Children with a history of motion sickness are more prone to postoperative vomiting. Sevoflurane is associated with a lower incidence of vomiting in children without a history of motion sickness compared to halothane.
Area of Science:
- Pediatric Anesthesiology
- Postoperative Care
- Pediatric Surgery
Background:
- Motion sickness is a significant risk factor for postoperative nausea and vomiting in children.
- Understanding this link is crucial for optimizing pediatric surgical care.
Purpose of the Study:
- To investigate the impact of motion sickness on vomiting incidence after routine pediatric surgery.
- To compare vomiting rates using halothane versus sevoflurane in pediatric anesthesia.
Main Methods:
- A prospective study of 420 children undergoing common pediatric surgery with combined anesthesia.
- Children were randomized into two groups: halothane (n=200) or sevoflurane (n=220).
- Data collected on prior history of motion sickness and postoperative vomiting episodes.
Main Results:
- Children with a history of motion sickness (MS+) had higher vomiting rates than those without (MS-).
- Vomiting incidence was similar between halothane and sevoflurane groups in MS+ children (approx. 33%).
- MS- children showed significantly higher vomiting incidence with halothane (19%) than sevoflurane (8%).
Conclusions:
- Postoperative vomiting is more frequent in children with a history of motion sickness, irrespective of the anesthetic agent.
- Sevoflurane use is associated with a lower incidence of vomiting in children without a history of motion sickness compared to halothane.
Background:
Motion sickness is considered an important risk factor for postoperative nausea and vomiting in children. The aim of this study was to verify the impact of motion sickness on the incidence of vomiting after routine surgery in children, and to compare the incidence of vomiting, after combined regional/general anaesthesia, using either halothane or sevoflurane.
Methods:
We prospectively studied 420 children (369 males and 51 females) who received general anaesthesia and inguinal field block for common paediatric surgery. The children were randomly allocated into one of two groups (halothane or sevoflurane). In the 200 children in the first group (H), general anaesthesia was induced and maintained with halothane, whereas in the 220 children in the second group (S), anaesthesia was induced and maintained with sevoflurane.
Results:
There were 79 children with a prior history of motion sickness (MS+) and 341 without such a history (MS-). In the MS+ population, the incidence of vomiting was similar in both H and S groups, being around 33%. However, repeated episodes of vomiting in MS+ children were more frequent when halothane was used. In the MS- group, the incidence of vomiting was significantly greater in the H group (19%) than in the S group (8%).
Conclusions:
In the postoperative period, we found that MS+ children vomit more than MS- children, regardless of the inhalation anaesthetic used. However, MS- children displayed a higher incidence of vomiting when halothane was used rather than sevoflurane.