title: Gastric residual volume in children: a study comparing efficiency of erythromycin and metoclopramide as prokinetic agents.
abstract: Metoclopramide may be used to stimulate gastric emptying when anaesthetizing children for emergency operations. Unfortunately, metoclopramide is associated with extrapyramidal side effects. Erythromycin, a motilin receptor agonist, is a prokinetic agent but its use has been little investigated in children. This randomized double-blind study compared the effects of premedication with oral metoclopramide 0.15 mg kg(-1) or erythromycin 1 mg kg(-1) on gastric emptying in 80 children undergoing tonsillectomy. Pre-operative fluids, premedication and anaesthetic technique were standardized and gastric volume was measured with an orogastric tube. Post-operative nausea and vomiting was recorded. Metoclopramide and erythromycin produced similar gastric volumes (0.29 and 0.24 ml kg(-1)) and there was no difference in post-operative vomiting. In the erythromycin group there were more patients with negative aspirates (45.9%) than in the metoclopramide group (35.1%), but the difference was not statistically significant. These results indicate that erythromycin may be as effective as metoclopramide as a prokinetic agent.
authors.affiliation: Department of Anaesthesia and Intensive Care Medicine, University of Wales College of Medicine, Cardiff, UK.
authors.forename: T F
authors.initials: TF
authors.lastname: Zatman
authors.forename: J E
authors.initials: JE
authors.lastname: Hall
authors.forename: M
authors.initials: M
authors.lastname: Harmer
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000932:Antiemetics / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004917:Erythromycin / Q000008:administration & dosage*; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects*; D005765:Gastrointestinal Agents / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage*; D009325:Nausea; D011183:Postoperative Complications; D011292:Premedication; D014068:Tonsillectomy; D014839:Vomiting
chemical_list: D000932:Antiemetics; D005765:Gastrointestinal Agents; D004917:Erythromycin; D008787:Metoclopramide