Related Experiment Video

Updated: Aug 3, 2026

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
06:59

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

Prophylaxis for vomiting by children after tonsillectomy: dexamethasone versus perphenazine

W Splinter1, D J Roberts

  • 1Department of Anaesthesia, Children's Hospital of Eastern Ontario and University of Ottawa, Canada. Splinter@cheo.on.ca

Anesthesia and Analgesia
|September 20, 1997
PubMed

Insights

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.
Abstract

More Related Videos

CO2-Lasertonsillotomy Under Local Anesthesia in Adults05:07

CO2-Lasertonsillotomy Under Local Anesthesia in Adults

Published on: November 6, 2019

Ear Plaster Therapy as a Safe and Effective Treatment for Gestational Vomiting05:33

Ear Plaster Therapy as a Safe and Effective Treatment for Gestational Vomiting

Published on: August 4, 2023

Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists01:27

Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists

5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists01:28

Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists

Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy.  SP binds and activates these...
Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists01:29

Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists

Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
Phenothiazines, such as prochlorperazine...
Tonsillitis II: Management01:26

Tonsillitis II: Management

This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...