Dolasetron for the prevention of postoperative vomiting in children undergoing strabismus surgery.
BACKGROUND
Children undergoing strabismus surgery have a high incidence of postoperative vomiting (POV). The purpose of this study was to assess the efficacy and safety of dolasetron for the prevention of emesis comparing a single 0.35 mg.kg-1 or 12.5 mg dose with placebo.


METHODS
Children aged 2-12 years with an ASA status of 1 or 2 undergoing strabismus surgery were randomized in a double-blind manner to one of three treatment groups. Patients were excluded with a history of previous postoperative vomiting or motion sickness, allergy to serotonin receptor antagonists or previous antiemetic administration within 24 h prior to enrollment. General anaesthesia was induced with sevoflurane and N2O/O2 and maintained with isoflurane and N2O/O2. The study medication was administered 15 min prior to the end of surgery. Patients experiencing two or more episodes of vomiting were rescued in the postanaesthesia care unit (PACU) with metoclopramide 0.15 mg.kg-1. A total of 118 patients were enrolled with documentation of the number and severity of vomiting episodes, time to awakening, PACU length of stay and postoperative agitation.


RESULTS
Patients with an acute complete response (ACR), defined as no emetic episodes and no rescue medication within 24 h of study drug administration were 62% (weight dose), 64% (fixed dose) and 33% (placebo, P < 0.05).


CONCLUSIONS
There was no statistical difference between the 0.35 mg.kg-1 dose and the fixed 12.5 mg dose of dolasetron with both reducing the incidence of POV.
Wagner
Deborah
D
University of Michigan Health Systems, Department of Pediatric Anesthesia, Ann Arbor, MI, USA. debbiew@umich.edu
Pandit
Uma
U
Voepel-Lewis
Terri
T
Weber
Monica
M
D000082:Acetaminophen / Q000627:therapeutic use; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000768:Anesthesia, General; D000932:Antiemetics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007211:Indoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D013508:Ophthalmologic Surgical Procedures; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011807:Quinolizines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013285:Strabismus / Q000601:surgery*
D018712:Analgesics, Non-Narcotic; D000932:Antiemetics; D007211:Indoles; D011807:Quinolizines; D000082:Acetaminophen; C060344:dolasetron