Ondansetron reduces nausea and vomiting after paediatric adenotonsillectomy
Related Experiment Videos
1Department of Paediatric Anaesthesia and Intensive Care, Royal Hospital for Sick Children, Yorkhill NHS Trust, Glasgow, Scotland, UK.
Insights
A single intravenous dose of ondansetron effectively reduced postoperative nausea and emesis in children undergoing tonsillectomy. This treatment also decreased the need for nursing interventions and resource utilization, improving patient outcomes.
Area of Science:
- Pediatric Anesthesiology
- Pharmacology
- Surgical Outcomes
Background:
- Postoperative nausea and vomiting (PONV) are common complications in pediatric surgery.
- Effective management of PONV is crucial for patient recovery and resource allocation.
- Ondansetron is a 5-HT3 receptor antagonist used to prevent nausea and vomiting.
Purpose of the Study:
- To evaluate the efficacy, safety, and resource implications of a single intravenous dose of ondansetron in pediatric patients undergoing tonsillectomy with or without adenoidectomy.
- To compare outcomes between ondansetron and placebo groups.
Main Methods:
- A multinational, multicenter, randomized, double-blind, placebo-controlled trial.
- Involved 427 children aged 1-12 years undergoing tonsillectomy +/- adenoidectomy.
- Assessed emesis and nausea separately, along with rescue medication use, nursing interventions, and resource management.
Main Results:
- Significantly more ondansetron-treated children experienced no emesis (60% vs 47%, P=0.004) and no nausea (64% vs 51%, P=0.004) in the first 24 hours.
- Ondansetron reduced emetic episodes (P<0.001), time to first emetic episode (P<0.001), and nausea severity (P=0.003).
- Fewer ondansetron patients required rescue (5% vs 10%, P=0.042), nursing intervention (34% vs 45%, P=0.007), and overall resources for PONV management were reduced (43% vs 57%, P=0.014).
Conclusions:
- A single intravenous dose of ondansetron is effective and safe for preventing and managing PONV in children undergoing tonsillectomy.
- Ondansetron significantly reduces the incidence and severity of PONV, leading to decreased need for interventions and better resource utilization.
- This study supports the use of ondansetron as a valuable tool in pediatric surgical care to improve patient comfort and streamline healthcare resources.
Abstract:
The efficacy, safety and resource implications of a single intravenous dose of ondansetron (0.1 mg.kg-1, maximum 4 mg) were assessed in a multinational, multicentre, randomized, double-blind, placebo-controlled trial of 427 children aged 1-12 years, undergoing tonsillectomy with/without adenoidectomy. Emesis (retching and/or vomiting) and nausea were analysed separately. Significantly more ondansetron-treated children had no episodes of emesis (127/212 (60%) vs 100/215 (47%); P = 0.004) and experienced no postoperative nausea (135/211 (64%) vs 108/213 (51%); P = 0.004) in the first 24 h. Ondansetron also reduced the number of emetic episodes (P < 0.001), the time to the first emetic episode (P < 0.001) and overall nausea severity (P = 0.003). Significantly fewer ondansetron-treated children were rescued or withdrawn from the study (5% vs 10%; P = 0.042). Fewer ondansetron-treated patients required nursing intervention (34% vs 45%; P = 0.007) and the average intervention time was significantly shorter (4.6 vs 8.1 minutes; P = 0.001). Resources used to manage PONV were significantly reduced by ondansetron (43% vs 57%; P = 0.014).