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.
Watcha
M F
MF
Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas 75235-9068.
Bras
P J
PJ
Cieslak
G D
GD
Pennant
J H
JH
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