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A double blind comparison of droperidol and ondansetron for prevention of emesis in children undergoing orthopaedic surgery
Author(s) -
GOODARZI MASHALLAH
Publication year - 1998
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1046/j.1460-9592.1998.00231.x
Subject(s) - ondansetron , medicine , droperidol , anesthesia , antiemetic , postoperative nausea and vomiting , fentanyl , vomiting , nausea , placebo , surgery , alternative medicine , pathology
Emesis is common in the postoperative period following epidural opioid and general anaesthesia. Eighty patients ages two to 14 years scheduled for major orthopaedic surgery were enrolled in a randomized, double‐blind study to compare the prophylactic effects of ondansetron, droperidol and a placebo for the prevention of postoperative emesis. Each child was assigned at random to one of the four treatment groups: ondansetron 100 μg·kg −1 , ondansetron 50 μg·kg −1 , droperidol 60 μg·kg −1 and saline control. Drugs were administered intravenously after the induction of anaesthesia. Anaesthesia was supplemented with epidural fentanyl, given as an infusion of 1 μg·kg −1 and continued for postoperative pain control. The incidence of vomiting in the immediate postoperative period was 25% with ondansetron (100 μg·kg −1 ), 40% with ondansetron (50 μg·kg −1 ) and droperidol and 70% with the control group. In the next 48 h the incidence of emesis increased to 30% for ondansetron (100 μg·kg −1 ), 55% with ondansetron (50 μg·kg −1 ), 65% with droperidol and 85% for the control group. Those patients who had multiple emesis necessitating a second dose of the same drug treatment showed no difference in the incidence of emesis relative to the control group. Ondansetron (50 μg·kg −1 ) and droperidol groups had lower incidence of PONV compared to the control group. The ondansetron (100 μg·kg −1 ) group had a significant decrease in the incidence of emesis. We conclude that the prophylactic administration of ondansetron (100 μg·kg −1 ) is more effective than droperidol and ondansetron (50 μg·kg −1 ) and superior to saline ( P <0.02) for the prevention of emesis before epidural opioid and general anaesthesia.