Ondansetron reduces nausea and vomiting after paediatric adenotonsillectomy.
The efficacy, safety and resource implications of a single intravenous dose of ondansetron (0.1 mg.kg-1, maximum 4 mg) were assessed in a multinational, multicentre, randomized, double-blind, placebo-controlled trial of 427 children aged 1-12 years, undergoing tonsillectomy with/without adenoidectomy. Emesis (retching and/or vomiting) and nausea were analysed separately. Significantly more ondansetron-treated children had no episodes of emesis (127/212 (60%) vs 100/215 (47%); P = 0.004) and experienced no postoperative nausea (135/211 (64%) vs 108/213 (51%); P = 0.004) in the first 24 h. Ondansetron also reduced the number of emetic episodes (P < 0.001), the time to the first emetic episode (P < 0.001) and overall nausea severity (P = 0.003). Significantly fewer ondansetron-treated children were rescued or withdrawn from the study (5% vs 10%; P = 0.042). Fewer ondansetron-treated patients required nursing intervention (34% vs 45%; P = 0.007) and the average intervention time was significantly shorter (4.6 vs 8.1 minutes; P = 0.001). Resources used to manage PONV were significantly reduced by ondansetron (43% vs 57%; P = 0.014).
Morton
N S
NS
Department of Paediatric Anaesthesia and Intensive Care, Royal Hospital for Sick Children, Yorkhill NHS Trust, Glasgow, Scotland, UK.
Camu
F
F
Dorman
T
T
Knudsen
K E
KE
Kvalsvik
O
O
Nellgard
P
P
Saint-Maurice
C P
CP
Wilhelm
W
W
Cohen
L A
LA
D000233:Adenoidectomy / Q000009:adverse effects*; D000758:Anesthesia / Q000009:adverse effects / Q000379:methods; D000932:Antiemetics / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous; D009325:Nausea / Q000209:etiology / Q000517:prevention & control*; D017294:Ondansetron / Q000008:administration & dosage* / Q000009:adverse effects; D014068:Tonsillectomy / Q000009:adverse effects*; D014839:Vomiting / Q000209:etiology / Q000517:prevention & control*
D000932:Antiemetics; D017294:Ondansetron