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Tropisetron reduces vomiting after tonsillectomy in children
1Department of Anaesthesia, Princess Margaret Hospital for Children, Perth, Australia.
Insights
Tropisetron effectively reduced postoperative nausea and vomiting in children undergoing tonsillectomy. This new antiemetic significantly decreased emetic episodes and severe vomiting compared to placebo.
Area of Science:
- Pediatric Anesthesiology
- Pharmacology
- Surgical Outcomes
Background:
- Postoperative nausea and vomiting (PONV) are frequent complications following adenotonsillectomy in children.
- Tropisetron, a serotonin antagonist, is a proven antiemetic in adults, but its efficacy in pediatric patients is not established.
Purpose of the Study:
- To evaluate the effectiveness of a single intravenous dose of tropisetron in preventing vomiting after pediatric tonsillectomy or adenotonsillectomy.
Main Methods:
- A randomized, double-blind, placebo-controlled trial involving 48 children undergoing tonsillectomy or adenotonsillectomy.
- Participants received either tropisetron (0.1 mg/kg) or placebo intravenously at anesthesia induction.
- Vomiting incidence was monitored for 24 hours post-surgery, with metoclopramide used as a rescue antiemetic.
Main Results:
- Tropisetron significantly reduced the overall incidence of emetic episodes (29% vs. 65% in the control group; P = 0.019).
- The incidence of severe vomiting was markedly lower in the tropisetron group (0% vs. 52% in the control group; P < 0.001).
Conclusions:
- Tropisetron is an effective antiemetic for managing PONV in children after tonsillectomy.
- This study supports the use of tropisetron for preventing vomiting in pediatric surgical patients.
Abstract:
Nausea and vomiting are common after adenotonsillectomy. Tropisetron is a new, long-acting serotonin antagonist that is an effective antiemetic in adults. Its effect on postoperative nausea and vomiting in children is unknown. We carried out a randomized, double-blind study of the effects of a single i.v. dose of tropisetron on vomiting after tonsillectomy with or without adenoidectomy in children. Forty-eight children undergoing tonsillectomy or adenotonsillectomy received at induction of anaesthesia either tropisetron 0.1 mg kg-1 or placebo. The incidence of vomiting was recorded for the first 24 h after surgery by nursing staff and then by parents after discharge from hospital. Children received metoclopramide 0.15 mg kg-1 as a rescue antiemetic. We found that tropisetron reduced the overall incidence of emetic episodes after surgery (29% compared with 65% in control group; P = 0.019) and the incidence of severe vomiting (0% compared with 52% in control group; P < 0.001). We conclude that tropisetron is an effective antiemetic for children undergoing tonsillectomy.