Single-dose ondansetron prevents postoperative vomiting in pediatric outpatients

被引:22
作者
Patel, RI
Davis, PJ
Orr, RJ
Ferrari, LR
Rimar, S
Hannallah, RS
Cohen, IT
Colingo, K
Donlon, JV
Haberkern, CM
McGowan, FX
Prillaman, BA
Parasuraman, TV
Creed, MR
机构
[1] GEORGE WASHINGTON UNIV,MED CTR,WASHINGTON,DC 20037
[2] CHILDRENS HOSP PITTSBURGH,DEPT ANESTHESIOL,PITTSBURGH,PA 15213
[3] CHILDRENS HOSP & MED CTR,DEPT ANESTHESIOL,SEATTLE,WA 98105
[4] MASSACHUSETTS EYE & EAR INFIRM,DEPT ANESTHESIOL,BOSTON,MA 02114
[5] YALE UNIV,SCH MED,DEPT ANESTHESIOL,NEW HAVEN,CT 06510
[6] GLAXO WELLCOME INC,RES TRIANGLE PK,NC 27709
关键词
D O I
10.1097/00000539-199709000-00011
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
This randomized, double-blind, parallel-group, multicenter study evaluated the safety and efficacy of ondansetron (0.1 mg/kg to 4 mg intravenously) compared with placebo in the prevention of postoperative vomiting in 429 ASA status I-III children 1-12 yr old undergoing outpatient surgery under nitrous oxide-and halothane-based general anesthesia. The results show that during both the 2-h and the 24-h evaluation periods after discontinuation of nitrous oxide, a significantly greater percentage of ondansetron-treated patients (2 h 89%, 24 h 68%) compared with placebo-treated patients (2 h 71%, 24 h 40%) experienced complete response (i.e., no emetic episodes, not rescued, and not withdrawn; P < 0.001 at both time points). Ondansetron-treated patients reached criteria for home readiness one-half hour sooner than placebo-treated patients (P < 0.05). The age of the child, use of intraoperative opioids, type of surgery, and requirement to tolerate fluids before discharge may also have affected the incidence of postoperative emesis during the 0- to 24-h observation period. Use of postoperative opioids did not have any effect on complete response rates in this patient population. We conclude that the prophylactic use of ondansetron reduces postoperative emesis in pediatric patients, regardless of the operant influential factors. Implications: Postoperative nausea and vomiting often occur after surgery and general anesthesia in children and are the major reason for unexpected hospital admission after ambulatory surgery. Our study demonstrates that the prophylactic use of a small dose of ondansetron reduces postoperative vomiting in pediatric patients.
引用
收藏
页码:538 / 545
页数:8
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