Ondansetron does not modify emergence agitation in children

Area of Science:

• Pediatric Anesthesiology
• Pharmacology

Background:

• Emergence agitation is a common complication in pediatric anesthesia.
• Ondansetron is an antiemetic drug with potential sedative effects.
• The efficacy of prophylactic ondansetron in preventing emergence agitation after sevoflurane anesthesia is not well-established.

Purpose of the Study:

• To evaluate the effect of prophylactic intravenous ondansetron on emergence agitation in children undergoing minor infraumbilical surgery.
• To compare the incidence and severity of emergence agitation between children receiving ondansetron and those receiving a placebo.

Main Methods:

• Prospective, placebo-controlled study involving 70 children aged 1-6 years.
• Children received midazolam premedication and caudal anesthesia, with random assignment to intravenous ondansetron or placebo post-induction.
• Emergence agitation was assessed using a ten-point scale and pain using the modified Children's Hospital of Eastern Ontario pain scale.

Main Results:

• No significant differences in demographic, anesthetic, or surgical characteristics between groups.
• Similar incidences of emergence agitation were observed: 32.4% in the ondansetron group and 30.3% in the placebo group at 10 minutes.
• Pain scores and agitation incidences decreased similarly in both groups post-operatively. Agitated patients had longer discharge times.

Conclusions:

• Prophylactic intravenous ondansetron does not significantly reduce emergence agitation in children after sevoflurane anesthesia and minor surgery.
• Ondansetron did not impact recovery time or pain scores compared to placebo.
• Further research may explore alternative strategies for managing emergence agitation in pediatric patients.