[Postoperative nausea and vomiting in outpatient surgery in younger children]

Area of Science:

• Pediatric Surgery
• Anesthesiology
• Pharmacology

Background:

• Postoperative nausea and vomiting (PONV) is a common and potentially dangerous complication in pediatric ambulatory surgery.
• Effective management of PONV is crucial for safe recovery and discharge in children.

Purpose of the Study:

• To develop a differentiated antiemetic therapy approach for young children in outpatient settings.
• To compare the efficacy of ondansetron versus metoclopramide for PONV prophylaxis in pediatric surgery.

Main Methods:

• A study involving 140 children (1-5 years, ASA I-II) undergoing planned surgery in a day-case hospital.
• Children received either metoclopramide (65) or ondansetron (75) for antiemetic therapy.
• A subgroup analysis assessed ondansetron efficacy in 1-3 year olds compared to no prevention.

Main Results:

• Ondansetron use resulted in a fourfold lower incidence of PONV compared to metoclopramide.
• PONV occurred significantly less frequently in children aged 1-3 years treated with ondansetron.
• Prevention with ondansetron was more effective in younger children (1-3 years) than in older children (3-5 years).

Conclusions:

• Ondansetron is a more effective antiemetic agent than metoclopramide for PONV prophylaxis in pediatric ambulatory surgery.
• A differentiated approach favoring ondansetron, especially in younger children, improves PONV management.
• Optimizing antiemetic strategies in pediatric day surgery can reduce complications and enhance patient safety.