Preoperative oral ondansetron for pediatric tonsillectomy.
This prospective, randomized, double-blind, placebo-controlled study evaluated the antiemetic efficacy of preoperative oral ondansetron, 0.075 mg/kg or 0.15 mg/kg, in 136 preadolescent children premedicated with midazolam 0.5 mg/kg per os and dexamethasone 0.1 mg/kg intravenously prior to undergoing tonsillectomy with isoflurane anesthesia. The incidence of vomiting during the 24 h after tonsillectomy was significantly reduced (P < 0.04) by ondansetron 0.15 mg/kg compared with placebo and ondansetron 0.075 mg/kg (15%, 38%, and 36%, respectively). There was a significant reduction (P < 0.03) in the mean number of vomiting episodes per patient during the 24 h immediately after tonsillectomy in the ondansetron 0.15 mg/kg group compared with the placebo and ondansetron 0.075 mg/kg study groups (0.2 +/- 0.6, 0.8 +/- 1.3, and 0.8 +/- 1.3, respectively). The need for antiemetic rescue therapy (ondansetron 0.15 mg/kg intravenously after three episodes of emesis prior to discharge) was significantly greater in children who received placebo compared with the ondansetron 0.15 mg/kg study group (13% vs 0%, P < 0.05). We conclude that ondansetron 0.15 mg/kg, administered orally prior to tonsillectomy, is associated with reduced postoperative vomiting in preadolescent children. In addition, the preoperative oral administration of ondansetron 0.075 mg/kg is no more effective than placebo in preventing posttonsillectomy vomiting in preadolescent children.
Rose
J B
JB
Department of Anesthesiology, Alfred I. duPont Institute, Wilmington, DE 19899, USA.
Brenn
B R
BR
Corddry
D H
DH
Thomas
P C
PC
D000284:Administration, Oral; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D000932:Antiemetics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003907:Dexamethasone / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007275:Injections, Intravenous; D007530:Isoflurane / Q000008:administration & dosage; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D017294:Ondansetron / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control; D011229:Preanesthetic Medication; D011292:Premedication; D011446:Prospective Studies; D014068:Tonsillectomy / Q000009:adverse effects; D014839:Vomiting / Q000188:drug therapy / Q000517:prevention & control
D018685:Anesthetics, Inhalation; D000932:Antiemetics; D006993:Hypnotics and Sedatives; D017294:Ondansetron; D003907:Dexamethasone; D007530:Isoflurane; D008874:Midazolam