Related Experiment Videos
Vomiting after strabismus surgery in children: ondansetron vs propofol
W M Splinter1, E J Rhine, D J Roberts
1Department of Anaesthesia, Children's Hospital of Eastern Ontario, Canada. splinter@cheo.on.ca
Insights
This study found that halothane-based anesthesia with ondansetron and propofol-based anesthesia had similar antiemetic efficacy in pediatric strabismus surgery. However, propofol-based anesthesia incurred higher drug costs.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Background:
- Postoperative nausea and vomiting (PONV) are common complications in pediatric surgery.
- Effective antiemetic prophylaxis is crucial for patient recovery and hospital resource management.
- Comparing anesthetic regimens for PONV prevention in pediatric strabismus surgery is important for optimizing care.
Purpose of the Study:
- To compare the antiemetic efficacy of two anesthetic regimens in children undergoing strabismus surgery.
- To evaluate the cost-effectiveness of halothane/nitrous oxide/ondansetron versus propofol/nitrous oxide anesthesia.
- To determine the impact of anesthetic choice on postoperative vomiting incidence and duration of hospital stay.
Main Methods:
- A single-blind, randomized, stratified, blocked study enrolled 300 children (aged 2-14 years) undergoing strabismus surgery.
- Anesthesia was induced with either halothane/nitrous oxide/oxygen (Group O) or propofol/lidocaine (Group P).
- Patients received ondansetron (Group O) or no antiemetic (Group P), along with atropine. Vomiting incidence and drug costs were assessed over 24 hours post-operation.
Main Results:
- Both anesthetic regimens demonstrated equal antiemetic efficacy, with an 11% incidence of in-hospital vomiting and 23% post-discharge.
- Each vomiting episode prolonged hospital discharge by an average of 17 minutes (P < 0.001).
- The mean cost of anesthetic drugs was significantly lower in the halothane/ondansetron group (CDN$18 ± 8) compared to the propofol group (CDN$21 ± 10, P < 0.01).
Conclusions:
- Halothane-based anesthesia with ondansetron and propofol-based anesthesia provide comparable antiemetic effectiveness in pediatric strabismus surgery.
- Propofol-based anesthesia is associated with higher drug costs compared to the halothane regimen.
- The findings suggest that the choice of anesthetic can impact healthcare costs without compromising antiemetic control.
Purpose:
To compare the antiemetic efficacy and costs associated with two anaesthetic regimens in children undergoing strabismus surgery. One regimen contained halothane, nitrous oxide and ondansetron, while the other contained propofol and nitrous oxide.
Methods:
Three hundred children aged 2-14 yr undergoing strabismus surgery were enrolled into this single-blind, randomized, stratified, blocked study with a balanced design. Anaesthesia was induced by inhalation with halothane/N2O/O2 (Group O) or with 2.5-3.5 mg.kg-1 propofol + 0.5 mg.kg-1 lidocaine i.v. (Group P). Group O patients were administered 0.15 mg.kg-1 ondansetron (maximum dose 8 mg) i.v. and all patients received atropine 20 micrograms.kg-1 i.v. immediately after induction of anaesthesia. Anaesthesia was maintained with N2O and halothane (Group O) or N2O and propofol (Group P). Patients were followed for 24 hr after their operation primarily to assess the incidence of postoperative vomiting. For each case, the costs of the anaesthetic drugs administered and their associated intravenous administration tubing were determined. Drug costs were those prevailing at the study site at the time of the investigation. Fixed costs, such as the cost of the anaesthetic equipment were not assessed.
Results:
Groups were similar with respect to demographic data. The incidence of vomiting in both groups was 11% while in-hospital and 23% after discharge. Each episode of in-hospital vomiting prolonged discharge by 17 +/- 4 min, P < 0.001. Mean cost per case for anaesthetic drugs was less in Group O, 18 +/- 8 vs 21 +/- 10, CDN$, mean +/- SD, P < 0.01.
Conclusion:
The two methods of antiemetic prophylaxis were equally effective. Propofol-based anaesthesia was more expensive.