Postoperative emesis following otoplasty in children

Area of Science:

• Anesthesiology
• Pediatric Surgery
• Pharmacology

Background:

• Postoperative nausea and vomiting (PONV) are common complications in pediatric surgery.
• Effective antiemetic strategies are crucial for improving patient recovery and comfort.
• Otoplasty is a common pediatric surgical procedure where PONV can impact recovery.

Purpose of the Study:

• To compare the efficacy of ondansetron, droperidol, and placebo in preventing PONV in children undergoing otoplasty.
• To evaluate the impact of these agents on the time to oral fluid and food ingestion post-surgery.

Main Methods:

• A randomized controlled trial involving 60 unpremedicated children aged 3-14 years scheduled for otoplasty.
• Patients were assigned to receive ondansetron (0.1 mg/kg), droperidol (75 mcg/kg), or placebo at anesthesia induction.
• Standard general anesthesia with thiopental, atracurium, and halothane was administered, avoiding intraoperative opioids.

Main Results:

• Ondansetron significantly reduced vomiting incidence (15%) compared to droperidol (40%) and placebo (60%) (p < 0.01).
• Children receiving ondansetron tolerated oral fluids and solids earlier (p < 0.001).
• No significant difference in vomiting or oral intake time was observed between droperidol and placebo groups.

Conclusions:

• Ondansetron is an effective antiemetic for pediatric otoplasty, improving recovery by reducing nausea and vomiting.
• Ondansetron facilitates earlier resumption of oral feeding compared to droperidol or placebo.
• While a transient nodal rhythm was noted with ondansetron, it was not clinically significant, and no other adverse events were reported.