Low-dose ondansetron with dexamethasone more effectively decreases vomiting after strabismus surgery in children than does high-dose ondansetron

被引:68
作者
Splinter, WM [1 ]
Rhine, EJ [1 ]
机构
[1] Childrens Hosp Eastern Ontario, Dept Anaesthesia, Ottawa, ON K1H 8L1, Canada
关键词
ambulatory surgery; antiemetic; costs;
D O I
10.1097/00000542-199801000-00013
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background: Ondansetron and dexamethasone have been observed to decrease the incidence of vomiting by children after general anesthesia. This study compared the effect of high-dose (150 mu g/kg) ondansetron with low-dose (50 mu g/kg) ondansetron plus 150 mu g/kg dexamethasone on the incidence of vomiting after strabismus in children. Methods: This study had a double-blind, blocked, stratified, randomized design. With parental consent and Hospital Ethics Committee approval, healthy children aged 2-14 yr who were undergoing elective strabismus surgery were studied. Anesthesia was induced intravenously with propofol or by inhalation with halothane and nitrous oxide. Patients in the high-dose group were given placebo plus 150 mu g/kg (maximum dose, 8 mg) of ondansetron intravenously, whereas patients in the low-dose group were given 150 mu g/kg dexamethasone (maximum dose, 8 mg) and 50 mu g/kg ondansetron intravenously In a double-blind manner, Anesthesia was maintained with halothane and nitrous oxide. All incidences of vomiting occurring as long as 24 h after anesthesia were recorded. Results: Three of the 200 patients enrolled in the study were excluded from data analysis. The groups were similar with respect to demographic data and potential confounding variables. Patients vomited from 0-12 times. The low-dose ondansetron plus dexamethasone group had a lower incidence of vomiting, 9% (95% CI = 4-17%) versus 28% (95% CI = 20-38%; p < 0.001). Only 1% of the patients in the low-dose ondansetron plus dexamethasone group vomited while in the hospital. Conclusions: Low-dose ondansetron plus dexamethasone is an effective prophylactic antiemetic combination for children undergoing strabismus surgery.
引用
收藏
页码:72 / 75
页数:4
相关论文
共 13 条
[1]  
BAXENDALE BR, 1993, ANAESTHESIA, V48, P961
[2]  
CATLIN FI, 1991, ARCH OTOLARYNGOL, V117, P649
[3]  
HANNALLAH RS, 1990, ANESTHESIA AMBULATOR, P131
[4]   COMPARISON OF DEXAMETHASONE AND ONDANSETRON IN THE PROPHYLAXIS OF EMESIS INDUCED BY MODERATELY EMETOGENIC CHEMOTHERAPY [J].
JONES, AL ;
HILL, AS ;
SOUKOP, M ;
HUTCHEON, AW ;
CASSIDY, J ;
KAYE, SB ;
SIKORA, K ;
CARNEY, DN ;
CUNNINGHAM, D .
LANCET, 1991, 338 (8765) :483-487
[5]  
MCKENZIE R, 1994, ANESTH ANALG, V79, P961
[6]   IATROGENIC HYPONATREMIA - A CAUSE OF DEATH FOLLOWING PEDIATRIC TONSILLECTOMY [J].
MCRAE, RG ;
WEISSBURG, AJ ;
CHANG, KW .
INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY, 1994, 30 (03) :227-232
[7]  
ROILA F, 1995, NEW ENGL J MED, V332, P1
[8]  
SPLINTER W, 1994, CAN J OPHTHALMOL, V29, P224
[9]   Vomiting after strabismus surgery in children: ondansetron vs propofol [J].
Splinter, WM ;
Rhine, EJ ;
Roberts, DJ .
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 1997, 44 (08) :825-829
[10]   ORAL ONDANSETRON DECREASES VOMITING AFTER TONSILLECTOMY IN CHILDREN [J].
SPLINTER, WM ;
BAXTER, MRN ;
GOULD, HM ;
HALL, LE ;
MACNEILL, HB ;
ROBERTS, DJ ;
KOMOCAR, L .
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 1995, 42 (04) :277-280