Ondansetron decreases postoperative vomiting in pediatric patients undergoing tonsillectomy and adenoidectomy

Lawhorn, C. David; Bower, Charles M.; Brown, Raeford E.; Schmitz, Michael L.; Kymer, Patti J.; Stoner, Jo Anne M.; Vollers, J. Michael; Shirey, Robert

doi:10.1016/0165-5876(95)01324-5

Cited by 30 publications

(12 citation statements)

References 33 publications

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“…The study drugs were given at induction of anaesthesia in almost all of the studies. This may not be optimal for ondansetron, which has a relatively short half-life of 3 h. This is not the case for granisetron and tropisetron, which have half-lives of 8-9 h. The differences in clinical efficacy between granisetron (with or without dexamethasone) and droperidol in the present study are consistent with the results of studies between ondansetron or tropisetron and droperidol [13,21,24,26], which found an improved clinical efficacy of ondansetron in comparison with droperidol. The size of our study was larger than most studies performed to date.…”

Section: Discussionsupporting

confidence: 82%

“…The results of these studies are not consistent with each other. Only a limited number of studies show a better efficacy of 5HT 3 -antagonists compared with droperidol on PONV [13,21,24,26], whereas most studies show 1999, 54, pages 1059-1068 ............................................................................................................................................................................................................................................ Table 6 Effects of type of surgery on the incidence of PONV ........................................................................................................................................................................................................................................... comparable efficacy [5-12, 14-23, 25]. Most of these studies were performed in gynaecological surgery or strabismus surgery.…”

Section: Discussionmentioning

confidence: 99%

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Double‐blind comparative study of droperidol, granisetron and granisetron plus dexamethasone as prophylactic anti‐emetic therapy in patients undergoing abdominal, gynaecological, breast or otolaryngological surgery

et al. 1999

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SummaryIn this double-blind study the clinical efficacy of a single pre-operative intravenous dose of droperidol 1.25 mg (137 patients), granisetron 1 mg (130 patients) and granisetron 1 mg plus dexamethasone 5 mg (130 patients) was investigated for the prevention of postoperative nausea and vomiting after gynaecological surgery, breast surgery, abdominal surgery and ear, nose and throat surgery. The incidence of nausea in the first 24 h postoperatively was 52% in the droperidol group, 48% in the granisetron group and 34% with the combination, respectively. Both granisetron and granisetron/dexamethasone performed better than droperidol in their effects on vomiting or combined nausea and vomiting (incidence in the first 24 h 22%, 18% and 42%, respectively). The number of emetic episodes during the 5-day study period was significantly higher in the droperidol group (198) than in the granisetron (73) Nausea and vomiting are unpleasant consequences of general anaesthesia. The cause of postoperative nausea and vomiting (PONV) is multifactorial. Several patientrelated factors may affect the incidence of PONV, such as age, gender, weight, motion-sickness and the extent of pre-operative anxiety. Anaesthesia-related factors include the experience of the anaesthetist, premedication, anaesthetic agent (propofol), use of opioids and technique of anaesthesia. The highest incidence of PONV is found in abdominal surgery, gynaecological surgery, laparoscopic surgery, ear nose and throat surgery and breast reductions.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Double‐blind comparative study of droperidol, granisetron and granisetron plus dexamethasone as prophylactic anti‐emetic therapy in patients undergoing abdominal, gynaecological, breast or otolaryngological surgery

et al. 1999

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“…In a randomized, double-blind, placebo-controlled study, ondansetron in a dose of 0.1 mg kg -1 (maximum 4 mg) and 0.15 mg kg -1 (maximum 8 mg), administered IV after inhalation induction of anesthesia, was effective for the prevention of POV after tonsillectomy in children [5,6,9,29,30]. Splinter et al compared the efficacy of ondansetron at 2 doses (0.05 and 0.15 mg kg -1 , maximum 8 mg) for the prophylaxis against POV.…”

Section: Serotonin Receptor Antagonistsmentioning

confidence: 99%

Current Management of Vomiting After Tonsillectomy in Children

Fujii

2009

CDS

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Formal retraction notice of article entitled Current Management of Vomiting after Tonsillectomy in Children (Curr Drug Saf. 2009 Jan;4(1):62-73) by Dr Y. Fujii. This article is being retracted as a result of: Failure of Dr. Fijii's institution as well as of himself to rationalize the legitimacy of the study and/or its data as stipulated in request by the Editors-in-Chief of the journals extended on April 9, 2012.

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“…Of these, four [19][20][21][22] were inappropriately randomised; in five trials [23][24][25][26][27] the number of patients per group was not indicated; in three, several doses of droperidol were given both as a prophylaxis of PONV and as a treatment of established PONV; [28][29][30] in three, data of adults and children were pooled and could not be separated; [31][32][33] two were duplicate reports of previously published full reports; 34,35 one studied the effect of the hormonal cycle on PONV; 3 6 and in one, six patients only were analysed per group. 3 7 We analysed data from 74 randomised controlled trials, published in 74 reports.…”

Section: Included and Excluded Trialsmentioning

confidence: 99%

Efficacy, dose-response, and adverse effects of droperidol for prevention of postoperative nausea and vomiting

Henzi

Sonderegger

Tramèr

2000

Can J Anesth/J Can Anesth

217

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Purpose: To estimate the efficacy and harm produced by droperidol in the prevention of postoperative nausea and vomiting (PONV). Methods: Systematic search (MEDLINE, EMBASE, Cochrane library, hand-searching, bibliographies, all languages, up to May 1999) for randomised comparisons of droperidol with placebo in surgical patients. Relevant end points were prevention of early PONV (up to six hours postoperatively), and late PONV (24 hr), and adverse effects. Combined data were analysed using relative risk and NNT. Results: In 76 trials, 5,351 patients received 24 different regimens of droperidol. The average incidence of early and late PONV in controls was 34% and 51%, respectively. Droperidol was more efficacious than placebo in preventing PONV. In adults, the anti-nausea effect was short-lived, and there was no dose-responsiveness; with 0.25 to 0.30 mg the number-needed-to-treat (NNT) to prevent early nausea was 5. For both early and late anti-vomiting efficacy there was dose-responsiveness; best efficacy was with 1.5 mg to 2.5 mg (NNT, 7). In children, there was dose-responsiveness; best efficacy was with 75 µg·kg -1 (NNT to prevent early and late vomiting, 4). Two children had extrapyramidal symptoms with droperidol (NNT in children, 91; in any patient, 408). There was dose-responsiveness for sedation and drowsiness (with 2.5 mg the NNT was 7.8). Droperidol prevented postoperative headache (NNT,. Conclusions: Droperidol is anti-emetic in the surgical setting. The effect on nausea is short-lived but more pronounced than the effect on vomiting. Sedation and drowsiness are dose-dependent, extrapyramidal symptoms are rare, and there is a protective effect against headache.Objectif : Évaluer l'efficacité et les effets négatifs du dropéridol utilisé pour la prévention de nausées et de vomissements postopératoires (NVPO). Méthode : Recherche documentaire systématique (MEDLINE, EMBASE, bibliothèque Cochrane, recherche manuelle, bibliographies, dans toutes les langues jusqu'à mai 1999) pour établir des comparaisons randomisées de dropéridol avec un placebo chez des patients de chirurgie. Les paramètres étudiés ont été la prévention des NVPO précoces (jusqu'à six heures après l'opération) et tardifs (24 h) et les effets indésirables. Les données combinées ont été analysées en utilisant le risque relatif et le nombre nécessaire au traitement (NNT). Résultats : Résultats : Pour 76 essais, 5 351 patients ont reçu 24 régimes différents de dropéridol. L'incidence moyenne de NVPO précoces et tardifs chez les témoins a été de 34 % et 51 %, respectivement. Le dropéridol a été plus efficace que le placebo pour prévenir les NVPO. Chez les adultes, l'effet anti-nausée a été de courte durée et il n'y a pas eu de réponse en fonction de la dose; avec 0,25 à 0,30 mg, le NNT pour prévenir les nausées précoces a été de 5. Pour prévenir efficacement les vomissements précoces et tardifs, il y avait une réponse dépendante de la dose; la plus efficace a été de 1,5 mg à 2,5 mg (NNT, 7). Chez les enfants, pas de réponse selon la dose; l'effica...

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Ondansetron decreases postoperative vomiting in pediatric patients undergoing tonsillectomy and adenoidectomy

Cited by 30 publications

References 33 publications

Double‐blind comparative study of droperidol, granisetron and granisetron plus dexamethasone as prophylactic anti‐emetic therapy in patients undergoing abdominal, gynaecological, breast or otolaryngological surgery

Double‐blind comparative study of droperidol, granisetron and granisetron plus dexamethasone as prophylactic anti‐emetic therapy in patients undergoing abdominal, gynaecological, breast or otolaryngological surgery

Current Management of Vomiting After Tonsillectomy in Children

Efficacy, dose-response, and adverse effects of droperidol for prevention of postoperative nausea and vomiting

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