Antiemetic prophylaxis for strabismus surgery

Droperidol can reduce the high incidence of vomiting after pediatric strabismus surgery; however, its use may be associated with sedation, delayed hospital discharge, dysphoria and extrapyramidal signs. Midazolam, a short-acting benzodiazepine with antiemetic properties, has few side effects and may be a suitable alternative. We prospectively compared the antiemetic effect of these two drugs in 393 healthy children aged 18 months to 14 years undergoing outpatient strabismus surgery. The children were randomly assigned to receive midazolam hydrochloride (50 micrograms/kg) (199 patients) or droperidol (50 micrograms/kg) (194 children). The incidence rates of vomiting in the two groups were 45% and 37% respectively, a nonsignificant difference. The incidence of vomiting was not affected by the duration of anesthesia, but the number of muscles repaired was a significant predictor of postoperative vomiting (p < 0.001).