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Ondansetron reduces the incidence and severity of poststrabismus repair vomiting in children
J B Rose1, T M Martin, D H Corddry
1Department of Anesthesiology, Alfred I. duPont Institute, Wilmington, Delaware 19899.
Insights
Ondansetron significantly reduced vomiting in children after strabismus surgery compared to placebo. This antiemetic is effective in preventing post-operative nausea and vomiting in pediatric patients.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Background:
- Post-operative nausea and vomiting (PONV) is a common complication in pediatric patients undergoing strabismus repair.
- Effective antiemetic strategies are crucial for improving patient recovery and satisfaction.
Purpose of the Study:
- To compare the efficacy of ondansetron and metoclopramide as antiemetics in children undergoing strabismus surgery.
- To evaluate the incidence and severity of PONV in pediatric patients receiving ondansetron, metoclopramide, or placebo.
Main Methods:
- A prospective, randomized, placebo-controlled, double-blinded study was conducted with 90 pediatric patients (2-17 years) classified as ASA physical status I or II.
- Participants received intravenous ondansetron (0.15 mg/kg), metoclopramide (0.25 mg/kg), or normal saline (placebo) after anesthetic induction.
- Vomiting incidence and episodes were recorded prior to discharge and within 24 hours post-surgery.
Main Results:
- Ondansetron significantly reduced the incidence of vomiting compared to placebo both before discharge (10% vs. 50%) and within 24 hours post-surgery (30% vs. 67%).
- The number of vomiting episodes per patient was significantly lower in the ondansetron group (0.1 pre-discharge, 1.2 within 24h) compared to placebo (1.1 pre-discharge, 4.5 within 24h).
- Metoclopramide also showed a reduced incidence of vomiting compared to placebo, but ondansetron demonstrated superior efficacy.
Conclusions:
- Intravenous ondansetron at 0.15 mg/kg is highly effective in reducing the incidence and severity of PONV in children undergoing strabismus repair.
- Ondansetron provides significant antiemetic benefits both in the immediate post-operative period and up to 24 hours after surgery.
- Ondansetron is a valuable therapeutic option for managing PONV in pediatric surgical patients.
Abstract:
This prospective, randomized, placebo-controlled, double-blinded study evaluated the antiemetic efficacy of ondansetron and metoclopramide in 90 ASA physical status I or II children, 2-17 yr of age, undergoing strabismus repair. After anesthetic induction and prior to eye muscle manipulation, subjects received normal saline 0.3 mL/kg (Group 1), metoclopramide 0.25 mg/kg (Group 2), or ondansetron 0.15 mg/kg (Group 3), intravenously. There were no differences between groups with respect to age, weight, gender, fluids received, number of eye muscles repaired, anesthetic technique, or time in the operating room. The incidence of vomiting in Groups 1, 2, and 3 was 50%, 27%, and 10% prior to discharge, and 67%, 53%, and 30% during the 24 h after surgery, respectively. The number of children vomiting prior to discharge and within 24 h of surgery was significantly reduced in Group 3 compared with Group 1 (P < 0.003 and P < 0.015, respectively). The number of vomiting episodes per patient in Groups 1, 2, and 3 was 1.1, 0.5, and 0.1 prior to discharge, and 4.5, 2.6, and 1.2 during the 24 h after surgery (P < 0.0005 and P < 0.004, respectively). Ondansetron 0.15 mg/kg intravenously after the induction of anesthesia reduces the incidence and severity of vomiting after strabismus repair both prior to discharge from the hospital and during the 24 h after surgery.