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Perphenazine decreases vomiting by children after tonsillectomy
1Department of Anaesthesia, Children's Hospital of Eastern Ontario, Ottawa, Canada. Splinter@cheo.on.ca
Insights
Perphenazine effectively reduces post-tonsillectomy vomiting in children. This study found fewer vomiting episodes and less need for rescue antiemetics in children receiving perphenazine compared to placebo.
Area of Science:
- Pediatric Anesthesiology
- Pharmacology
- Surgical Outcomes
Background:
- Post-tonsillectomy nausea and vomiting (PONV) is a common complication in pediatric patients.
- Effective antiemetic prophylaxis is crucial for improving patient recovery and reducing hospital stay.
Purpose of the Study:
- To evaluate the efficacy of perphenazine in preventing vomiting in children following tonsillectomy.
- To test the hypothesis that perphenazine administration decreases the incidence of post-tonsillectomy emesis.
Main Methods:
- A randomized, double-blind, placebo-controlled trial involving 260 children aged 2-12 years undergoing tonsillectomy.
- Participants received either intravenous perphenazine (70 µg/kg, max 5 mg) or placebo before surgery.
- Standardized management of fluids, emesis, and pain was implemented.
Main Results:
- Perphenazine significantly reduced vomiting incidence within 24 hours post-surgery (42% vs. 57% in placebo group, P < 0.01).
- Fewer rescue antiemetics were required in the perphenazine group (P < 0.05).
- Each vomiting episode delayed hospital discharge by approximately 20 minutes.
Conclusions:
- Prophylactic perphenazine is effective in decreasing vomiting in children after tonsillectomy.
- Perphenazine improves outcomes by reducing emesis and potentially shortening hospital stays.
Purpose:
To test the hypothesis that perphenazine decreases the incidence of vomiting by children after tonsillectomy.
Methods:
Healthy children (n = 260) aged 2-12 yr undergoing elective tonsillectomy on a day care surgical basis were studied in this randomised. stratified, blocked, double-blind investigation. General Anaesthesia was induced intravenously with propofol or by inhalation with halothane and N2O. Perphenazine 70 micrograms.kg-1 up to 5 mg or placebo i.v. was administered before surgery. Management of perioperative fluids, emesis and pain were all standardised.
Results:
The groups were similar with respect to demographic data. There was less vomiting after perphenazine during the first 24 hr after surgery 42% (95% CI = 34%-50%) vs 57% (95% CI = 48%-66%, placebo), P < 0.01. On the day of surgery, both in and out-of hospital emesis were decreased by perphenazine. The perphenazine treated patients required fewer rescue antiemetics than the control group, P < 0.05. Each episode of in-hospital vomiting delayed discharge by 20 +/- 7 min (mean +/- SD), P = 0.007.
Conclusion:
The prophylactic administration of perphenazine decreases vomiting by children after tonsillectomy.