Economic evaluation of ondansetron vs dimenhydrinate for prevention of postoperative vomiting in children undergoing strabismus surgery.
BACKGROUND
Although rarely life-threatening, postoperative vomiting (POV) is a distressing complication. The incidence of POV ranges from 34 to 90% in children undergoing strabismus surgery when antiemetics are not administered prophylactically.


METHODS
In this study, a cost-consequence analysis (CCA) is used to estimate the economic benefit of ondansetron and dimenhydrinate as antiemetics administered prophylactically in children undergoing strabismus surgery. This retrospective study was conducted at The Hospital for Sick Children based on a review of 70 charts.


RESULTS
Ondansetron was more effective with 45.3 POV-free patients (PFP) in an adjusted cohort of 100, while dimenhydrinate resulted in 38.2 PFP in an adjusted cohort of 100. The costs were significantly different between the two groups, CAD dollars 185.90 (+/-26.37, 95% CI, CAD dollars 173,89; CAD dollars 197.90) and CAD dollars 232.90 (+/-CAD dollars 66.84, 95% CI, CAD dollars 198.53; CAD dollars 267.27) per patient for ondansetron and dimenhydrinate, respectively. The length of stay in the postanesthetic care unit (PACU) represented over 97% of total costs, and the mean lengths of stay in the PACU for ondansetron and dimenhydrinate were significantly different, 3.43 and 4.41 h, respectively.


CONCLUSIONS
This study should serve as a pilot for a large-scale investigation on the correlation between the length of stay in the PACU and the antiemetic agent used.
Piwko
Charles
C
Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Lasry
Arielle
A
Alanezi
Khaled
K
Coyte
Peter C
PC
Ungar
Wendy J
WJ
D000932:Antiemetics / Q000191:economics* / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D006282:Health Personnel / Q000191:economics; D006801:Humans; D007902:Length of Stay; D008297:Male; D017294:Ondansetron / Q000191:economics* / Q000627:therapeutic use*; D009864:Ontario; D010865:Pilot Projects; D020250:Postoperative Nausea and Vomiting / Q000191:economics* / Q000517:prevention & control*; D012189:Retrospective Studies; D013285:Strabismus / Q000601:surgery*
D000932:Antiemetics; D017294:Ondansetron