Transcutaneous electrical acupoint stimulation versus ondansetron in the prevention of postoperative vomiting following pediatric tonsillectomy.
OBJECTIVE
Postoperative retching and vomiting is an important cause of morbidity that may lead to patient discomfort, distress, and complications. Stimulation of acupuncture points has been shown to be effective in the prevention as well as treatment of PONV. The current treatments of choice are the 5-hydroxytryptamine type 3-antagonists, such as ondansetron. We aimed to evaluate the efficacy and side-effects of either transcutaneous electrical acupoint stimulation (TEAS) or Ondansetron compared to a control group receiving no treatment in the prevention of postoperative retching and vomiting. SUBJECT AND DESIGN: This randomized, controlled, prospective study was carried out in a group of 90 children (in three equal randomly assigned groups), aged between 4 and 12 who underwent tonsillectomy under general anesthesia. In the first group, electrical stimulation via surface electrodes on acupoints Neiguan and Shangwan was performed (20 Hz, 5 minutes). The second group received a single dose of Ondansetron (0.15 mg . kg(-1)). No treatment was given to the control group.


METHODS
The frequency of retching and vomiting attacks and side-effects were noted on the day of surgery in the postanesthesia care unit and the day surgery care unit, on the day of surgery after discharge, and on the first day after surgery. A satisfaction scale was completed by each family.


RESULTS
There was a significant difference between the treatment groups and the control group in the incidence of emetic episodes occurring in the day surgery care unit and on the day after discharge (p < 0.001). In the ondansetron group, side-effects were seen in more patients than in the other groups (p < 0.001). The satisfaction scores of the parents were greater in the treatment groups than in the control group (p < 0.05).


CONCLUSIONS
Application of TEAS on sedated children is an easy, painless, reliable and effective method for the prophylaxis of postoperative retching and vomiting in pediatric tonsillectomy.
Kabalak
Ayla A
AA
Department of Anesthesiology and Reanimation, Numune Education and Research Hospital, Ankara, Turkey. drayla2002@yahoo.com
Akcay
Murat
M
Akcay
Feryal
F
Gogus
Nermin
N
D000932:Antiemetics / Q000008:administration & dosage*; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D015671:Electroacupuncture / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D017294:Ondansetron / Q000008:administration & dosage*; D010290:Parents; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014068:Tonsillectomy / Q000009:adverse effects; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods; D016896:Treatment Outcome
D000932:Antiemetics; D017294:Ondansetron