Tropisetron reduces vomiting after tonsillectomy in children

Nausea and vomiting are common after adenotonsillectomy. Tropisetron is a new, long-acting serotonin antagonist that is an effective antiemetic in adults. Its effect on postoperative nausea and vomiting in children is unknown. We carried out a randomized, double-blind study of the effects of a single i.v. dose of tropisetron on vomiting after tonsillectomy with or without adenoidectomy in children. Forty-eight children undergoing tonsillectomy or adenotonsillectomy received at induction of anaesthesia either tropisetron 0.1 mg kg(-1) or placebo. The incidence of vomiting was recorded for the first 24 h after surgery by nursing staff and then by parents after discharge from hospital. Children received metoclopramide 0.15 mg kg(-1) as a rescue antiemetic. We found that tropisetron reduced the overall incidence of emetic episodes after surgery (29% compared with 65% in control group; P = 0.019) and the incidence of severe vomiting (0% compared with 52% in control group; P < 0.001). We conclude that tropisetron is an effective antiemetic for children undergoing tonsillectomy.