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Prophylaxis for vomiting by children after tonsillectomy: dexamethasone versus perphenazine
1Department of Anaesthesia, Children's Hospital of Eastern Ontario and University of Ottawa, Canada. Splinter@cheo.on.ca
Anesthesia and Analgesia
|September 20, 1997
Summary
Perphenazine significantly reduced vomiting after pediatric tonsillectomy compared to dexamethasone in a hospital setting. While perphenazine was more effective before discharge, both drugs showed similar effects after patients left the hospital.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Background:
- Postoperative vomiting is a common and debilitating complication in children following tonsillectomy.
- Identifying effective antiemetic strategies is crucial for improving patient outcomes and recovery.
- Dexamethasone and perphenazine are commonly used agents, but their comparative efficacy in this specific context requires further investigation.
Purpose of the Study:
- To compare the efficacy of dexamethasone and perphenazine in preventing and treating postoperative vomiting in children undergoing tonsillectomy.
- To evaluate the impact of these drugs on both in-hospital and out-of-hospital vomiting episodes.
Main Methods:
- A randomized, double-blind, stratified, and blocked study involving 226 healthy children aged 2-12 years.
- Administration of intravenous dexamethasone (150 microg/kg) or perphenazine (70 microg/kg) post-anesthesia induction.
- Standardized perioperative management for emesis, pain, fluids, and patient discharge.
Main Results:
- Perphenazine significantly reduced in-hospital vomiting incidence compared to dexamethasone (13% vs. 36%, P < 0.001).
- Overall vomiting incidence was significantly lower with perphenazine (33% vs. 46%, P = 0.04).
- Male sex and intravenous induction were identified as significant predictors of reduced postoperative vomiting.
Conclusions:
- Perphenazine demonstrates superior efficacy in decreasing postoperative vomiting in children after tonsillectomy within an ambulatory hospital setting compared to dexamethasone.
- The observed differences in efficacy were primarily noted before hospital discharge.
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