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Related Experiment Videos

Antiemetic prophylaxis for strabismus surgery

W Splinter1, L P Noël, D Roberts

  • 1Department of Anaesthesia, Children's Hospital of Eastern Ontario, Ottawa.

Canadian Journal of Ophthalmology. Journal Canadien D'Ophtalmologie
|October 1, 1994
PubMed
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Midazolam and droperidol showed similar effectiveness in preventing vomiting after pediatric strabismus surgery. The number of eye muscles repaired, not anesthesia duration, predicted postoperative vomiting incidence.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pharmacology

Background:

  • Postoperative nausea and vomiting (PONV) is common after pediatric strabismus surgery.
  • Droperidol is effective but associated with adverse effects like sedation and extrapyramidal signs.
  • Midazolam, a benzodiazepine, offers potential antiemetic benefits with fewer side effects.

Purpose of the Study:

  • To prospectively compare the antiemetic efficacy of midazolam versus droperidol in children undergoing outpatient strabismus surgery.
  • To evaluate the safety and side effect profiles of both agents in this pediatric population.

Main Methods:

  • A prospective, randomized study involving 393 healthy children (18 months to 14 years) undergoing strabismus surgery.
  • Patients were randomly assigned to receive either midazolam hydrochloride (50 µg/kg) or droperidol (50 µg/kg).

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  • Incidence of postoperative vomiting was the primary outcome measure.

    • Main Results:

    • Vomiting incidence was 45% in the midazolam group and 37% in the droperidol group, a statistically nonsignificant difference.
    • Neither anesthesia duration nor patient age significantly affected vomiting rates.
    • The number of extraocular muscles repaired was a significant predictor of postoperative vomiting (p < 0.001).

    Conclusions:

    • Midazolam and droperidol demonstrate comparable antiemetic effects for pediatric strabismus surgery.
    • Midazolam may be a viable alternative to droperidol, potentially offering a better side effect profile.
    • Surgical factors, specifically the number of muscles repaired, are critical in predicting PONV in this setting.