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Intravenous dextrose versus ondansetron for prevention of postoperative vomiting in children: a randomized

Andrea Vasquez-Camargo1, Jonathan Gamble2, Kelly A Fedoruk3

  • 1Department of Academic Family Medicine, University of Saskatchewan, 172-1621 Albert Street, Regina, SK, S4P 2S5, Canada. a.vasquez@usask.ca.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|July 23, 2020
PubMed

Insights

Intravenous dextrose did not effectively prevent postoperative vomiting (POV) in children undergoing ambulatory surgery, unlike ondansetron. These findings do not support dextrose as a substitute for ondansetron in pediatric dental procedures.

Area of Science:

  • Pediatric Anesthesiology
  • Pharmacology

Background:

  • Postoperative vomiting (POV) is common in children.
  • Dextrose-containing IV fluids show promise for POV reduction in adults.
  • Pediatric studies on dextrose for POV prevention are limited.

Purpose of the Study:

  • To evaluate the efficacy of intraoperative intravenous dextrose for antiemetic prophylaxis in pediatric ambulatory surgery.
  • To determine if dextrose is non-inferior to ondansetron in preventing POV.

Main Methods:

  • A non-inferiority randomized clinical trial involving healthy children (3-9 years) undergoing ambulatory dental surgery.
  • Comparison of dexamethasone + ondansetron versus dexamethasone + intravenous dextrose.
  • Primary outcome: POV in the postanesthetic care unit (PACU) within 2 hours.

Main Results:

  • Vomiting in the PACU occurred in 7.6% of the dextrose group and 3.5% of the ondansetron group.
  • The risk difference was 4.2%, exceeding the non-inferiority margin of 7.5%.
  • Non-inferiority of dextrose compared to ondansetron was not demonstrated.

Conclusions:

  • Intravenous dextrose is not a satisfactory alternative to ondansetron for preventing POV in pediatric ambulatory dental surgery.
  • Further research may be needed to explore alternative antiemetic strategies.
Abstract

Keywords:
anesthesiachilddexamethasonegeneralglucoseondansetronpostoperative nausea and vomiting

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