title: Retrospective review of three antiemetic regimens versus no therapy in the prevention of  postoperative and vomiting following adenotonsillar surgery.
abstract: OBJECTIVE
  To study the effect of intraoperative ondansetron and dexamethasone on postoperative vomiting in children undergoing tonsillectomy, adenotonsillectomy, or adenoidectomy.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Academic tertiary care referral centre in the west of Scotland.
  
  
  METHODS
  A retrospective chart review was conducted on 432 children admitted to our institute between 2004 and 2006. Of these, 285 (66%) patients underwent a tonsillectomy, 50 (11.6%) an adenotonsillectomy, and 97 (22.4%) an adenoidectomy. There was an equal gender distribution, with a mean age of 7.4 years (interquartile range 4.6-10.0). Patients were divided into four groups: group 1 received ondansetron plus dexamethasone (n  =  64, 14.7%), group 2 received ondansetron only (n  =  189, 43.6%), group 3 received dexamethasone only (n  =  17, 3.9%), and group 4 did not receive ondansetron or dexamethasone (n  =  162, 37.4%).
  
  
  RESULTS
  Overall, 98 (22.7%) patients experienced postoperative vomiting (5 at the time of recovery and 93 on the ward). Patients in group 1 had a significantly lower incidence of postoperative vomiting than those in group 2 (10.9% vs 22.8%, p  =  .04) and group 4 (10.9% vs 27.2%, p < .01). The incidence of postoperative vomiting was also lower in group 1 than in group 3, but this did not reach statistical significance (10.9% vs 23.5%, p  =  .18).
  
  
  CONCLUSIONS
  The combined intraoperative use of ondansetron and dexamethasone appears to be superior to no antiemetic or ondansetron alone in reducing the incidence of vomiting in children undergoing adenotonsillar surgery.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Aberdeen Royal Infirmary, University of Aberdeen, Aberdeen, AB25 2ZN, Scotland. drshakeel@doctors.org.uk
authors.forename: Muhammad
authors.initials: M
authors.lastname: Shakeel
authors.forename: Aaron
authors.initials: A
authors.lastname: Trinidade
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al-Adhami
authors.forename: Imran
authors.initials: I
authors.lastname: Khan
authors.forename: Mrinal
authors.initials: M
authors.lastname: Supriya
authors.forename: Haytham
authors.initials: H
authors.lastname: Kubba
mesh_terms: D000233:Adenoidectomy; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D011182:Postoperative Care / Q000379:methods*; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology; D014068:Tonsillectomy; D016896:Treatment Outcome; D014839:Vomiting / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D000932:Antiemetics