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[Prophylactic effect of diphenhydramine on postoperative vomiting in children after laparoscopic surgery]

Akira Nakagawachi1, Jun Yoshino, Daisuke Miura

  • 1Department of Anesthesia, Fukuoka Children's Hospital and Medical Center for Infectious Diseases, Fukuoka 810-0063.

Masui. the Japanese Journal of Anesthesiology
|September 28, 2012
PubMed

Insights

Prophylactic diphenhydramine significantly reduced postoperative vomiting in pediatric patients undergoing laparoscopic inguinal hernia repair. However, this intervention was associated with prolonged sedation.

Area of Science:

  • Pediatric Surgery
  • Anesthesiology
  • Pharmacology

Background:

  • Laparoscopic percutaneous extraperitoneal closure (LPEC) is an alternative to open inguinal hernia repair in children.
  • LPEC is associated with a higher incidence of postoperative vomiting (POV).

Purpose of the Study:

  • To evaluate the efficacy of prophylactic diphenhydramine in reducing POV after LPEC in pediatric patients.

Main Methods:

  • A randomized controlled trial involving 60 girls (1-6 years old) undergoing LPEC.
  • Patients received either intravenous diphenhydramine (1 mg/kg) or placebo during surgery.
  • Anesthesia involved air-oxygen-sevoflurane and epidural anesthesia, with avoidance of opioids.

Main Results:

  • The incidence of POV within 24 hours was significantly lower in the diphenhydramine group (6.7%) compared to the placebo group (56.7%).
  • Wake-up time in the ward was significantly prolonged in the diphenhydramine group.

Conclusions:

  • Prophylactic diphenhydramine effectively reduces postoperative vomiting in children undergoing LPEC.
  • The benefit of reduced POV must be weighed against the risk of prolonged sedation.
Abstract

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