Vomiting after adenotonsillectomy in children: A comparison of ondansetron, dimenhydrinate, and placebo

被引:58
作者
Hamid, SK
Selby, IR
Sikich, N
Lerman, J
机构
[1] Hosp Sick Children, Dept Anaesthesia, Toronto, ON M5G 1X8, Canada
[2] Hosp Sick Children, Res Inst, Toronto, ON M5G 1X8, Canada
[3] Univ Toronto, Toronto, ON, Canada
关键词
D O I
10.1097/00000539-199803000-00008
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
We compared the effectiveness of ondansetron, dimenhydrinate, and placebo for the prevention of postoperative vomiting in children after adenotonsillectomy. In a randomized, placebo-controlled, double-blind study, 74 children, 2-10 yr of age scheduled for adenotonsillectomy as outpatients were given a single IV dose of ondansetron (0.1 mg/kg, n = 26), dimenhydrinate (0.5 mg/kg, n = 25), or placebo (saline, n = 23) at induction of anesthesia. The incidence of retching and vomiting (POV) and side effects observed 24 h after surgery were recorded. Demographic data were similar among the three groups. The 24-h incidence of POV was 42%, 79%, and 82% in the ondansetron, dimenhydrinate, and placebo groups, respectively (ondansetron compared with dimenhydrinate [P < 0.02] or placebo [P < 0.01]). The study was stopped after two children vomited large volumes of bloody fluid 9 and 22 h after surgery without previous signs of occult bleeding. Both children had received ondansetron. We conclude that ondansetron is superior to dimenhydrinate or placebo for the prevention of POV after adenotonsillectomy in children. Antiemetics may mask the signs of bleeding after adenotonsillectomy. Implications: TV ondansetron (0.1 mg/kg) is more effective than both dimenhydrinate and placebo in preventing vomiting after adenotonsillectomy in healthy children. However, antiemetics may also mask the presence of blood in the stomach by preventing vomiting, and this should be appreciated when adenotonsillectomy is performed on an outpatient basis.
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页码:496 / 500
页数:5
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