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Nausea and vomiting after strabismus surgery in preschool children
Insights
Postoperative nausea and vomiting (PONV) is common in young children after strabismus surgery. Droperidol did not reduce PONV, and glycopyrrolate showed no benefit over atropine.
Area of Science:
- Pediatric Anesthesiology
- Ophthalmology
- Pharmacology
Background:
- Postoperative nausea and vomiting (PONV) is a significant concern following strabismus surgery in children.
- Understanding the efficacy of different antiemetic agents and anticholinergics is crucial for optimizing patient care.
Purpose of the Study:
- To investigate the incidence of PONV in children aged one to six years undergoing strabismus surgery.
- To evaluate the effectiveness of droperidol and compare glycopyrrolate with atropine in preventing PONV.
Main Methods:
- A double-blind, randomized study involving 64 children compared intravenous droperidol with saline.
- An open, randomized comparison of intravenous glycopyrrolate and atropine was also performed.
- Incidence of emetic symptoms was assessed in the post-anesthesia recovery room, same-day surgery unit, and at home on postoperative days one and two.
Main Results:
- The highest incidence of emetic symptoms occurred in the same-day surgery unit and at home on day one post-operation.
- Droperidol slightly delayed awakening but did not significantly alter PONV rates in this age group.
- Glycopyrrolate provided no significant advantage over atropine in managing postoperative emesis.
Conclusions:
- Neither droperidol nor glycopyrrolate demonstrated significant benefits in reducing PONV after strabismus surgery in young children.
- The choice between glycopyrrolate and atropine for anticholinergic effects did not impact PONV outcomes.
- Further research may be needed to identify effective PONV prophylaxis strategies for this pediatric population.
Abstract:
The incidence of nausea and vomiting after strabismus surgery was studied in 64 children aged one to six years. Incidence was determined in the post-anaesthesia recovery room (PARR), in the same day surgery (SDS) unit, and at home on days one and two after the operation. After induction of anaesthesia, the children received an intravenous injection of droperidol (50 micrograms . kg-1) or saline in a double-blind randomized fashion, and an intravenous injection of glycopyrrolate (7.5 micrograms . kg-1) or atropine (10 micrograms . kg-1) in an open randomized fashion. The incidence of emetic symptoms was highest in the SDS unit and at home on day one. Droperidol slightly but significantly delayed awakening and was not, at least in this particular age group, associated with any difference in postoperative sickness. Despite theoretical advantages, glycopyrrolate offered no significant benefit over atropine as far as postoperative emesis was concerned.