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Metoclopramide reduces the incidence of vomiting after tonsillectomy in children
1Department of Anesthesia, Massachusetts Eye & Ear Infirmary, Boston 02114.
Insights
Intravenous metoclopramide significantly reduced post-tonsillectomy vomiting in children. This study found a 47% incidence in the metoclopramide group versus 70% in the placebo group, demonstrating its antiemetic efficacy.
Area of Science:
- Pediatric Anesthesiology
- Pharmacology
- Surgical Outcomes
Background:
- Post-tonsillectomy nausea and vomiting (PONV) are common in pediatric patients.
- Effective antiemetic strategies are crucial for improving pediatric surgical recovery.
- Metoclopramide is a dopamine antagonist with known antiemetic properties.
Purpose of the Study:
- To evaluate the efficacy of intravenous metoclopramide in preventing vomiting after tonsillectomy in children.
- To compare the incidence of vomiting between children receiving metoclopramide and those receiving a placebo.
Main Methods:
- Prospective, randomized, double-blind investigation involving 102 pediatric patients (1-15 years).
- Participants received either intravenous metoclopramide (0.15 mg/kg) or saline placebo post-anesthesia.
- Vomiting episodes were recorded for 24 hours following surgery.
Main Results:
- The incidence of vomiting was significantly lower in the metoclopramide group (47%) compared to the placebo group (70%) (P = 0.026).
- Intravenous metoclopramide demonstrated a statistically significant reduction in post-tonsillectomy vomiting.
Conclusions:
- Intravenous metoclopramide at a dose of 0.15 mg/kg is effective in decreasing the incidence of vomiting in children after tonsillectomy.
- Metoclopramide administration in the postanesthesia care unit is a viable strategy for managing pediatric PONV.
Abstract:
The efficacy of intravenous metoclopramide in controlling vomiting in children after tonsillectomy was determined in a prospective randomized, double-blind investigation. One hundred two unpremedicated, ASA physical status I or II children between the ages of 1 and 15 yr who were undergoing surgical removal of the tonsils, with or without adenoidectomy, were studied. Anesthesia was induced either with halothane, nitrous oxide, and oxygen by mask or by intravenous thiopental and was maintained with halothane, nitrous oxide, oxygen, and intravenous morphine (0.1 mg/kg). Each child randomly received either 0.15 mg/kg of metoclopramide or saline solution placebo intravenously after transfer to the postanesthesia care unit. All episodes of vomiting were recorded for 24 h after completion of surgery. The incidence of vomiting in the saline solution group was 70%, compared with 47% in the metoclopramide group (P = 0.026). The authors conclude that the administration of intravenous metoclopramide in a dose of 0.15 mg/kg on arrival in the postanesthesia care unit significantly decreases the incidence of vomiting in children after tonsillectomy.