Preoperative Oral Ondansetron for Pediatric Tonsillectomy

• Published in: Anesthesia and analgesia Vol. 82; no. 3; pp. 558 - 562
• Main Authors: Rose, John B., Brenn, B. Randall, Corddry, David H., Thomas, Phyllis C.
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD International Anesthesia Research Society 01-03-1996; Lippincott
• Subjects: Administration, Oral; Anesthesia, Inhalation; Anesthetics, Inhalation - administration & dosage; Antiemetics - therapeutic use; Biological and medical sciences; Child; Child, Preschool; Dexamethasone - therapeutic use; Digestive system; Double-Blind Method; Female; Humans; Hypnotics and Sedatives - administration & dosage; Injections, Intravenous; Isoflurane - administration & dosage; Male; Medical sciences; Midazolam - administration & dosage; Ondansetron - therapeutic use; Pharmacology. Drug treatments; Postoperative Complications - prevention & control; Preanesthetic Medication; Premedication; Prospective Studies; Tonsillectomy - adverse effects; Vomiting - drug therapy; Vomiting - prevention & control; Human; Prevention; Chemotherapy; Tonsillectomy; Vomiting; Surgery; Oral administration; Digestive diseases; Complication; Child; Antiemetic
• ISSN: 0003-2999; 1526-7598
• DOI: 10.1097/00000539-199603000-00023

This prospective, randomized, double-blind, placebo-controlled study evaluated the antiemetic efficacy of preoperative oral ondansetron, 0.075 mg/kg or 0.15 mg/kg, in 136 preadolescent children premedicated with midazolam 0.5 mg/kg per os and dexamethasone 0.1 mg/kg intravenously prior to undergoing tonsillectomy with isoflurane anesthesia. The incidence of vomiting during the 24 h after tonsillectomy was significantly reduced (P < 0.04) by ondansetron 0.15 mg/kg compared with placebo and ondansetron 0.075 mg/kg (15%, 38%, and 36%, respectively). There was a significant reduction (P < 0.03) in the mean number of vomiting episodes per patient during the 24 h immediately after tonsillectomy in the ondansetron 0.15 mg/kg group compared with the placebo and ondansetron 0.075 mg/kg study groups (0.2 +/- 0.6, 0.8 +/- 1.3, and 0.8 +/- 1.3, respectively). The need for antiemetic rescue therapy (ondansetron 0.15 mg/kg intravenously after three episodes of emesis prior to discharge) was significantly greater in children who received placebo compared with the ondansetron 0.15 mg/kg study group (13% vs 0%, P < 0.05). We conclude that ondansetron 0.15 mg/kg, administered orally prior to tonsillectomy, is associated with reduced postoperative vomiting in preadolescent children. In addition, the preoperative oral administration of ondansetron 0.075 mg/kg is no more effective than placebo in preventing posttonsillectomy vomiting in preadolescent children.(Anesth Analg 1996;82:558-62)