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Addition of droperidol to prophylactic ondansetron and dexamethasone in children at high risk for postoperative

N Bourdaud1, C François1, O Jacqmarcq2

  • 1Service d'Anesthésie Réanimation, Hôpital Universitaire Necker, Université Paris Descartes Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris, Paris, France.

British Journal of Anaesthesia
|May 16, 2017
PubMed

Insights

Adding droperidol to dexamethasone and ondansetron did not reduce postoperative vomiting in children. The combination of dexamethasone and ondansetron is recommended for high-risk pediatric patients to prevent nausea and vomiting.

Area of Science:

  • Anesthesiology
  • Pediatric Pharmacology
  • Clinical Trial Research

Background:

  • Postoperative nausea and vomiting (PONV) is a common concern in pediatric surgery.
  • The combination of dexamethasone (DEX), ondansetron (OND), and droperidol (DRO) is effective in adults but less studied in children.
  • High-risk pediatric patients require optimized antiemetic prophylaxis.

Purpose of the Study:

  • To evaluate the efficacy of adding droperidol to DEX and OND for preventing postoperative vomiting (POV) in high-risk children.
  • To assess the impact of droperidol on the incidence of POV and adverse events.
  • To determine the optimal antiemetic regimen for pediatric patients undergoing elective surgery.

Main Methods:

  • A randomized controlled trial involving children aged 3-16 undergoing elective surgery.
  • Group A received DEX, OND, and placebo; Group B received DEX, OND, and DRO.
  • Primary outcome: incidence of POV within 24 hours; Secondary outcome: adverse events.

Main Results:

  • No significant difference in POV incidence between groups (10.5% vs. 11.1%, P=0.86).
  • Fewer adverse events in the placebo group (2% vs. 8%, P=0.01), primarily drowsiness and headache.
  • Droperidol did not provide additional benefit in reducing POV but increased adverse events.

Conclusions:

  • Adding droperidol to DEX and OND does not improve POV prevention in high-risk children.
  • The combination of DEX and OND is recommended for high-risk pediatric patients.
  • DEX and OND combination offers a favorable risk-benefit profile for pediatric PONV prophylaxis.
Abstract

Keywords:
antiemeticschildpostoperative nausea and vomiting

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