Prevention of post-operative nausea and vomiting in children--a prospective randomized double-blind study.
OBJECTIVE
Post-operative nausea and vomiting (PONV) are common complications related to surgery and anaesthesia. The aim of this study was to assess whether sevoflurane, with or without the use of an antiemetic such as ondansetron, increases or not the incidence of PONV in children.


METHODS
One hundred and ten children, 2 months to 14 years undergoing inguinal hernia, hypospadias and penile deformity repair, were randomly allocated into one of two groups, according to whether they received ondansetron or placebo (47 vs. 63). Induction and maintenance of anaesthesia was with Sevoflurane in both groups. Regional anaesthesia was performed on all children (inguinal nerve, penile or caudal block). No opioids were used. In post-operative period, children were assessed for PONV, every 4 h for the first 24 h.


RESULTS
Vomiting was very low in both groups (8 cases: 7.3%). No significant statistical difference of post-operative nausea (p = 0.296) and vomiting (p = 0.462) (Fisher's exact test) was found between the group that received ondansetron and the placebo group.


CONCLUSIONS
We found that the use of ondansetron did not change the incidence of PONV, the avoidance of opioids and the adequate analgesia may contribute to this. Post-operative oral intake of liquid, (within the first 4 h), increases the risk for PONV.
Sakellaris
G
G
Department of Paediatric Surgery, University Hospital of Heraklio, Greece. gsakell@mycosmos.gr
Georgogianaki
P
P
Astyrakaki
E
E
Michalakis
M
M
Dede
O
O
Alegakis
A
A
Makatounaki
K
K
Charissis
G
G
D000293:Adolescent; D018685:Anesthetics, Inhalation / Q000009:adverse effects / Q000627:therapeutic use; D000932:Antiemetics / Q000627:therapeutic use*; D002648:Child; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008738:Methyl Ethers / Q000009:adverse effects; D017294:Ondansetron / Q000627:therapeutic use*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011446:Prospective Studies; D012307:Risk Factors; D000077149:Sevoflurane; D013997:Time Factors
D018685:Anesthetics, Inhalation; D000932:Antiemetics; D008738:Methyl Ethers; D000077149:Sevoflurane; D017294:Ondansetron