title: [Tropisetron for prevention of nausea and vomiting in children undergoing tonsillectomy and/or adenoidectomy].
abstract: BACKGROUND
  Postoperative nausea and vomiting (PONV) after tonsillectomy is a common problem in children. Tropisetron is a new 5HT3 receptor antagonist and is successfully used in paediatric patients receiving cancer therapy. The aim of the study was to assess efficacy and safety of a single intravenous dose of tropisetron for prevention of PONV in paediatric patients at risk for postoperative vomiting.
  
  
  METHODS
  In a randomised, double-blind, placebo-controlled trial, we studied 98 children aged 2-12 years undergoing tonsillectomy or adenotonsillectomy. Patients received placebo or tropisetron 0.1 mg (= 0.1 ml)/kg body weight immediately after induction of anesthesia. A standard general anesthetic technique (Sevoflurane/N2O/O2 without neuromuscular blockers or opioids) was used. Perioperative vital signs, grade of sedation and episodes of postoperative nausea and vomiting were recorded.
  
  
  RESULTS
  No vomiting episodes occurred in 65.3% of the tropisetron treated patients compared to 34.7% of the placebo group (p = 0.0024). Only 10.2% of the tropisetron treated patients vomited more than 3 times compared to 22.4% of the control patients (p = 0.0004). The need for antiemetic rescue medication was significantly lower in the study group (10.4%) compared to 28.6% (p = 0.025). No significant adverse effects of the study medication were shown.
  
  
  CONCLUSIONS
  A single intravenous prophylactic dose of tropisetron effectively reduces the incidence of PONV during the first 24 postoperative hours after tonsillectomy and/or adenoidectomy. Because of the low incidence of adverse effects, the prophylactic use of tropisetron seems to be safe and justified in paediatric surgical patients at high risk for postoperative vomiting.
authors.affiliation: Anästhesieabteilung, Universitäts-Kinderklinik Zürich. claudia.dillier@kispi.unizh.ch
authors.forename: C M
authors.initials: CM
authors.lastname: Dillier
authors.forename: M
authors.initials: M
authors.lastname: Weiss
authors.forename: A C
authors.initials: AC
authors.lastname: Gerber
mesh_terms: D000233:Adenoidectomy; D000932:Antiemetics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D008297:Male; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D014068:Tonsillectomy; D000077526:Tropisetron
chemical_list: D000932:Antiemetics; D007211:Indoles; D000077526:Tropisetron