The dose-response relationship of ondansetron in preventing postoperative emesis in pediatric patients undergoing ambulatory surgery.
BACKGROUND
Postoperative nausea and vomiting is a distressing anesthetic complication that may delay discharge after ambulatory surgery. Effective prophylaxis for postoperative nausea and vomiting can be achieved in adults with lower doses of ondansetron, a 5-hydroxytryptamine subtype 3 receptor antagonist, compared with chemotherapy-induced emesis. However, the doses of ondansetron used in preventing postoperative nausea and vomiting in children are based on data from chemotherapy-induced emesis. The dose-related efficacy of intravenous ondansetron in the prophylaxis of postoperative emesis in the pediatric outpatient population was determined.


METHODS
In a double-blind, randomized placebo-controlled study, 130 patients (mean age 5.7 +/- 3.4 yr) received placebo, 10, 50, or 100 micrograms/kg ondansetron during a standardized anesthetic. Episodes of postoperative vomiting or retching were recorded.


RESULTS
Intravenous ondansetron in a dose of 50 micrograms/kg was more effective than placebo or a dose of 10 micrograms/kg in controlling the incidence and frequency of emesis in the hospital and during the first 24 postoperative hours. Increasing the dose of ondansetron to 100 micrograms/kg intravenously did not significantly reduce the incidence or frequency of emesis compared to 50 micrograms/kg intravenously.


CONCLUSIONS
Intravenous ondansetron in a dose of 50 micrograms/kg is as effective as larger doses for the prophylaxis of emesis in children undergoing surgical procedures known to be associated with an increased risk for postoperative nausea and vomiting.
Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas 75235-9068.
M F
MF
Watcha
P J
PJ
Bras
G D
GD
Cieslak
J H
JH
Pennant
D000556:Ambulatory Surgical Procedures; D000768:Anesthesia, General; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006221:Halothane; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D009325:Nausea / Q000517:prevention & control*; D009609:Nitrous Oxide; D017294:Ondansetron / Q000008:administration & dosage / Q000494:pharmacology*; D010149:Postoperative Pain / Q000188:drug therapy; D011183:Postoperative Complications / Q000517:prevention & control*; D011229:Preanesthetic Medication; D014839:Vomiting / Q000517:prevention & control*
D017294:Ondansetron; D009609:Nitrous Oxide; D006221:Halothane