The addition of antiemetics to the morphine solution in patient controlled analgesia syringes used by children after an appendicectomy does not reduce the incidence of postoperative nausea and vomiting

Munro, F J; Fisher, Susan M.; Dickson, U.; Morton, Neil S.

doi:10.1046/j.1460-9592.2002.00900.x

Cited by 19 publications

(16 citation statements)

References 26 publications

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“…While many researchers have shown a benefit when ondansetron was added to PCA, at least one study showed no beneficial effect [12]. Concentration of ondansetron in the other studies varied from 0.13 mg/mL [10,16] to 0.32 mg/mL [14], well below the concentration of one mg/mL used in our study.…”

Section: Discussioncontrasting

confidence: 67%

“…The addition of ondansetron to PCA for treatment of PONV is not new [10,12,14,16]. While many researchers have shown a benefit when ondansetron was added to PCA, at least one study showed no beneficial effect [12].…”

Section: Discussionmentioning

confidence: 99%

“…Antiemetics evaluated include propofol, metoclopramide, ondansetron, tropisetron, prochlorperamide, and droperidol [5][6][7][8][9][10][11][12][13][14][15][16][17][18]. In several reports, droperidol decreased vomiting without affecting nausea.…”

Section: Introductionmentioning

confidence: 99%

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Patient-controlled analgesia combined with either ondansetron or ondansetron plus prochlorperazine for control of pain and nausea and vomiting in patients undergoing abdominal surgery

Jellish

Owen

Fluder

et al. 2008

Journal of Clinical Anesthesia

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Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

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Patient-controlled analgesia combined with either ondansetron or ondansetron plus prochlorperazine for control of pain and nausea and vomiting in patients undergoing abdominal surgery

Jellish

Owen

Fluder

et al. 2008

Journal of Clinical Anesthesia

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“…Adding antiemetics directly to PCA solutions for children was not effective (Munro et al, 2002 Level II). Addition of a low-dose naloxone infusion did not impair analgesia, but decreased pruritus and nausea in postoperative children treated with PCA (Maxwell et al, 2005 Level II) and also decreased pruritus in children requiring morphine infusions during a sickle cell crisis (Koch et al, 2008 Level IV).…”

Section: The Pca Prescriptionmentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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“…Adult studies have shown significant reductions in nausea and vomiting when ondansetron (Zofran ® , GlaxoSmithKline plc., London, UK) or droperidol were added to an intravenous PCA opioid, but these positive effects have not been confirmed in children [106].…”

Section: Patient-controlled Analgesiamentioning

confidence: 99%

Current management of pediatric postoperative pain

Kokki¹

2004

Expert Review of Neurotherapeutics

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Pain is a common complaint in children after surgery. Four out of five children require analgesia even after minor surgery, and after more extensive surgery, significant postoperative pain may last for weeks. Severe pain during, and after surgery may aggravate long-lasting negative effects to the body and mind. In order to prevent harmful effects, all children should be provided with effective analgesia. Pain management should be safe and easy to administer. Postoperative pain management in children has improved substantially during the last 5 years. Recent trials indicate that children may undergo major surgery with minimal untoward effects when effective proactive pain management is provided. This review will focus on new clinical strategies on pain management in children. Since most pediatric surgery is performed as a day-case or short-stay basic recommendations for parental guidance and pain management after discharge are also presented.

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The addition of antiemetics to the morphine solution in patient controlled analgesia syringes used by children after an appendicectomy does not reduce the incidence of postoperative nausea and vomiting

Abstract: We were unable to show any significant benefit from the prophylactic administration of ondansetron or droperidol to children using morphine PCA devices following appendicectomy in the doses we employed.

Cited by 19 publications

References 26 publications

Patient-controlled analgesia combined with either ondansetron or ondansetron plus prochlorperazine for control of pain and nausea and vomiting in patients undergoing abdominal surgery

Patient-controlled analgesia combined with either ondansetron or ondansetron plus prochlorperazine for control of pain and nausea and vomiting in patients undergoing abdominal surgery

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Current management of pediatric postoperative pain

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