title: [Prophylactic effect of diphenhydramine on postoperative vomiting in children after laparoscopic surgery].
abstract: BACKGROUND
  Laparoscopic percutaneous extraperitoneal closure (LPEC), introduced as an alternative to a conventional open inguinal hernia repair in children, has shown a higher incidence of postoperative vomiting (POV). The aim of this study was to examine whether a prophylactic use of diphenhydramine can decrease the incidence of POV in children undergoing LPEC.
  
  
  METHODS
  We studied 60 girls between 1 and 6 years of age with ASA physical status I or II undergoing LPEC. Patients were allocated to receive either diphenhydramine 1 mg x kg(-1) intravenously (n = 30) or placebo (n = 30) during the operation. Anesthesia was performed with air-oxygen-sevoflurane in combination with epidural anesthesia. Opioids were avoided throughout the perioperative period. The incidence of POV was recorded postoperatively.
  
  
  RESULTS
  Demographic data were similar between the groups. The overall incidence of POV during the first 24 postoperative hours was significantly higher in the placebo group (56.7%) than in the diphenhydramine (6.7%) group (P < 0.01). The wake-up in the ward was significantly prolonged in the diphenhydramine group than control group.
  
  
  CONCLUSIONS
  Prophylactic use of diphenhydramine substantially reduced the risk of postoperative vomiting, but was associated with prolonged sedation in pediatric patients undergoing LPEC.
authors.affiliation: Department of Anesthesia, Fukuoka Children's Hospital and Medical Center for Infectious Diseases, Fukuoka 810-0063.
authors.forename: Akira
authors.initials: A
authors.lastname: Nakagawachi
authors.forename: Jun
authors.initials: J
authors.lastname: Yoshino
authors.forename: Daisuke
authors.initials: D
authors.lastname: Miura
authors.forename: Kaoru
authors.initials: K
authors.lastname: Izumi
authors.forename: Nobuo
authors.initials: N
authors.lastname: Jimi
authors.forename: Rieko
authors.initials: R
authors.lastname: Sumiyoshi
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Mizuno
mesh_terms: D000762:Anesthesia Recovery Period; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D000932:Antiemetics / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004155:Diphenhydramine / Q000008:administration & dosage*; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008738:Methyl Ethers; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011446:Prospective Studies; D000077149:Sevoflurane; D013997:Time Factors
chemical_list: D000932:Antiemetics; D008738:Methyl Ethers; D000077149:Sevoflurane; D004155:Diphenhydramine