Posttonsillectomy vomiting. Ondansetron or metoclopramide during paediatric tonsillectomy: are two doses better than one?
This randomized, double blinded, placebo controlled, prospective study compared the anti-emetic efficacy of one preoperative dose of metoclopramide 0.25 mg.kg-1 intravenously or ondansetron 0.15 mg.kg-1 intravenously with two doses of the same drugs (second dose administered one h postoperatively) in 200 preadolescent children undergoing tonsillectomy with either isoflurane or propofol anaesthesia. The incidence of posttonsillectomy vomiting was significantly reduced (P < 0.005) by two doses of either metoclopramide or ondansetron (18% and 8%, respectively) compared with placebo (50%). No difference in posttonsillectomy vomiting exists between the children who received isoflurane and those who received a propofol infusion. Our results suggest that two doses of metoclopramide 0.25 mg.kg-1 intravenously, like two doses of ondansetron 0.15 mg.kg-1, are effective in reducing vomiting after tonsillectomy in children who have received either isoflurane or propofol anaesthesia.
Rose
J B
JB
Department of Pediatric Anesthesiology, Alfred I. duPont Institute, Wilmington, DE 19899, USA.
Martin
T M
TM
D000704:Analysis of Variance; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015994:Incidence; D007275:Injections, Intravenous; D007530:Isoflurane / Q000008:administration & dosage; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage / Q000627:therapeutic use*; D017294:Ondansetron / Q000008:administration & dosage / Q000627:therapeutic use*; D010919:Placebos; D011183:Postoperative Complications; D011292:Premedication; D015742:Propofol / Q000008:administration & dosage; D011446:Prospective Studies; D014068:Tonsillectomy / Q000009:adverse effects; D014839:Vomiting / Q000517:prevention & control*
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000932:Antiemetics; D010919:Placebos; D017294:Ondansetron; D007530:Isoflurane; D008787:Metoclopramide; D015742:Propofol