Postoperative emesis after pediatric strabismus surgery: the effect of dixyrazine compared to droperidol

Abstract

Sixty-one children, ASA physical status I, aged 2-14 years, admitted for strabismus surgery were studied. All were premedicated with diazepam and atropin rectally. Anesthesia was induced with thiopental or with halothane on a facemask, and succinylcholine was given to facilitate tracheal intubation. Anesthesia was maintained with halothane and nitrous oxide. Each child was randomly assigned to receive either no antiemetic prophylaxis (control), droperidol 0.075 mg/kg, or dixyrazine 0.25 mg/kg. The drugs were injected intravenously at the end of surgery. The incidence of vomiting during the following 24 h was 65% in the control group, 48% in the droperidol group, and 25% in the dixyrazine group (P less than 0.05 as compared to the control group). Four hours after the operation, six children in the droperidol group and none in the dixyrazine group (P less than 0.05) were difficult to arouse. It is concluded that dixyrazine reduces the incidence of postoperative vomiting without causing heavy sedation.

Anticholinergic prophylaxis does not prevent emesis following strabismus surgery in children

“…The 22-30% incidence of emetic symptoms in this study was low compared with the 41435% reported by other workers (Abramowitz et al 1983;Hardy et al 1986;Broadman et al 1990;Larsson & Johmarker 1990;Horimoto et al 1991). In this study, narcotics the postoperative period.…”

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

“…We extrapolated variable doses in adults to fixed doses assuming an average bodyweight of 60 kg. In children, only variable doses (5,10,20,40,50,75,200, or 300 µg·kg -1 ), orally or intravenously, were given. Most pediatric trials analysed prevention of vomiting only.…”

“…There were data on 13,352 patients, of whom 5,351 (43%) received droperidol, 3,372 received a placebo or "no treatment", and 4,629 received another anti-emetic intervention. A "no treatment" control was used in fourteen trials, 59,63,65,66,73,75,76,80,83,98,[108][109][110][111] all others used placebos. Data from "no treatment" groups were regarded as placebos.…”

Effects of droperidol dosage on postoperative emetic symptoms following pediatric strabismus surgery

“…2 Sedation was assessed using a four-level Alertness Scale (0 ϭ fully awake, 1 ϭ drowsy, 2 ϭ asleep but easy to arouse, and 3 ϭ asleep and difficult to arouse). 3 Emetic symptoms were defined to be nausea, retching, or vomiting. The time and occurrence of any emetic symptom was recorded.…”

“…Predischarge emetic symptoms were 50%, 15%, 15%, and 5% in Groups 1, 2, 3, and 4, respectively (p Ͻ 0.009). Peak emetic symptoms were observed after discharge: 75%, 40%, 35%, and 15% in Groups 1,2,3,and 4, respectively (p Ͻ 0.003). Convalescence times, including awakening, extubation, recovery, and hospitalization, were unaffected by increasing droperidol dose.…”