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A double-blind randomized prospective study comparing ondansetron with droperidol in the prevention of emesis
Abstract:
A prospective double-blind study was conducted to compare the anti-emetic efficacy of ondansetron and droperidol in preventing postoperative emesis following strabismus surgery. A sample size of 213 patients was divided into three equal groups to receive ondansetron 150 micrograms/kg (Group A), ondansetron 75 micrograms/kg (Group B), or droperidol 75 micrograms/kg (Group C). All patients received a standardized anaesthetic technique. All episodes of emesis, recovery time, and time to tolerating oral fluids were recorded. The incidence of emesis during 24 hours was Groups A and B 19.7%, and Group C 28.2%. The lower incidence of emesis recorded by the ondansetron groups compared with the droperidol group was not statistically significant. Ondansetron at 75 micrograms/kg was as effective as 150 micrograms/kg in reducing emesis when compared with droperidol. Mean time to discharge from the recovery room was 75.3 minutes (Group A), 44.4 minutes (Group B), and 41.0 minutes (Group C). The mean time to tolerating oral fluids was 356.5 minutes (Group A), 402.8 minutes (Group B), and 378.1 minutes (Group C). There was no statistical difference in discharge times from recovery or time to tolerating oral fluids in any of the three groups.
Insights
Ondansetron effectively prevents postoperative emesis after strabismus surgery. Both 75 and 150 micrograms/kg doses of ondansetron showed comparable efficacy to droperidol, with no significant difference in outcomes.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Postoperative nausea and vomiting (PONV) are common complications after anesthesia and surgery.
- Strabismus surgery, particularly in pediatric patients, is associated with a significant risk of emesis.
- Ondansetron and droperidol are established anti-emetic agents used to manage PONV.
Purpose of the Study:
- To compare the anti-emetic efficacy of two doses of ondansetron against droperidol in preventing postoperative emesis.
- To evaluate the impact of ondansetron and droperidol on recovery time and oral fluid tolerance following strabismus surgery.
Main Methods:
- A prospective, double-blind study involving 213 patients undergoing strabismus surgery.
- Patients were randomized into three groups receiving either ondansetron 150 mcg/kg, ondansetron 75 mcg/kg, or droperidol 75 mcg/kg.
- Standardized anesthetic techniques were employed, and emesis episodes, recovery time, and time to oral fluid tolerance were recorded.
Main Results:
- The incidence of emesis within 24 hours was 19.7% for both ondansetron groups (A and B) and 28.2% for the droperidol group (C).
- While ondansetron groups showed a lower incidence of emesis, the difference compared to droperidol was not statistically significant.
- No statistically significant differences were observed in mean recovery room discharge times or time to tolerating oral fluids among the three groups.
Conclusions:
- Ondansetron, at both 75 mcg/kg and 150 mcg/kg, demonstrated comparable anti-emetic efficacy to droperidol in preventing postoperative emesis after strabismus surgery.
- The 75 mcg/kg dose of ondansetron was as effective as the higher dose in reducing emesis compared to droperidol.
- Neither drug significantly impacted recovery time or oral fluid tolerance in this patient population.