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Postoperative emesis after pediatric strabismus surgery: the effect of dixyrazine compared to droperidol
1Department of Anesthesiology, University Hospital, Lund, Sweden.
Insights
Dixyrazine effectively reduced postoperative vomiting in children undergoing strabismus surgery. This antiemetic provided better results than droperidol without causing significant sedation.
Area of Science:
- Pediatric Anesthesiology
- Pharmacology
Background:
- Postoperative nausea and vomiting (PONV) are common complications in pediatric anesthesia.
- Effective antiemetic prophylaxis is crucial for patient recovery and comfort.
Purpose of the Study:
- To compare the efficacy and safety of dixyrazine versus droperidol for PONV prophylaxis in children.
- To evaluate the impact of these antiemetics on postoperative sedation levels.
Main Methods:
- A randomized controlled trial involving 61 children (aged 2-14 years) undergoing strabismus surgery.
- Participants received either droperidol, dixyrazine, or no antiemetic (control) post-surgery.
- Incidence of vomiting and sedation were assessed over 24 hours.
Main Results:
- Dixyrazine significantly reduced vomiting incidence (25%) compared to controls (65%) and droperidol (48%).
- No children in the dixyrazine group experienced significant sedation, unlike six in the droperidol group.
- P-values indicate statistically significant differences in vomiting and sedation outcomes.
Conclusions:
- Dixyrazine is an effective antiemetic for preventing PONV in pediatric strabismus surgery.
- Dixyrazine offers a favorable safety profile, avoiding the heavy sedation associated with droperidol.
Abstract:
Sixty-one children, ASA physical status I, aged 2-14 years, admitted for strabismus surgery were studied. All were premedicated with diazepam and atropin rectally. Anesthesia was induced with thiopental or with halothane on a facemask, and succinylcholine was given to facilitate tracheal intubation. Anesthesia was maintained with halothane and nitrous oxide. Each child was randomly assigned to receive either no antiemetic prophylaxis (control), droperidol 0.075 mg/kg, or dixyrazine 0.25 mg/kg. The drugs were injected intravenously at the end of surgery. The incidence of vomiting during the following 24 h was 65% in the control group, 48% in the droperidol group, and 25% in the dixyrazine group (P less than 0.05 as compared to the control group). Four hours after the operation, six children in the droperidol group and none in the dixyrazine group (P less than 0.05) were difficult to arouse. It is concluded that dixyrazine reduces the incidence of postoperative vomiting without causing heavy sedation.