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Preoperative oral ondansetron for pediatric tonsillectomy
J B Rose1, B R Brenn, D H Corddry
1Department of Anesthesiology, Alfred I. duPont Institute, Wilmington, DE 19899, USA.
Anesthesia and Analgesia
|March 1, 1996
Summary
A higher dose of ondansetron (0.15 mg/kg) effectively reduced postoperative vomiting in children undergoing tonsillectomy. Lower doses (0.075 mg/kg) showed no significant benefit over placebo for preventing post-tonsillectomy nausea and vomiting.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Background:
- Postoperative nausea and vomiting (PONV) is a common complication in pediatric tonsillectomy.
- Effective antiemetic strategies are crucial for improving patient recovery and satisfaction.
Purpose of the Study:
- To evaluate the antiemetic efficacy of two different oral doses of ondansetron (0.075 mg/kg and 0.15 mg/kg) in preadolescent children undergoing tonsillectomy.
- To compare the efficacy of ondansetron with a placebo in preventing postoperative vomiting.
Main Methods:
- Prospective, randomized, double-blind, placebo-controlled study.
- 136 preadolescent children received midazolam and dexamethasone premedication.
- Oral ondansetron (0.075 mg/kg or 0.15 mg/kg) or placebo was administered preoperatively.
Main Results:
- Ondansetron 0.15 mg/kg significantly reduced the incidence of vomiting compared to placebo and the lower dose (15% vs 38% and 36%).
- The mean number of vomiting episodes was significantly lower in the 0.15 mg/kg ondansetron group (0.2) versus placebo (0.8).
- Fewer children in the 0.15 mg/kg ondansetron group required antiemetic rescue therapy (0% vs 13% for placebo).
Conclusions:
- Preoperative oral ondansetron at 0.15 mg/kg is effective in reducing postoperative vomiting after tonsillectomy in preadolescent children.
- A lower dose of 0.075 mg/kg did not demonstrate superior efficacy compared to placebo for preventing post-tonsillectomy vomiting.