A randomized clinical trial comparing oral ondansetron with placebo in children with vomiting from acute gastroenteritis

Ramsook, Chris; Sahagun-Carreon, Ivonne; Kozinetz, Claudia A.; Moro-Sutherland, Donna

doi:10.1067/mem.2002.122706

Cited by 149 publications

(184 citation statements)

References 23 publications

(19 reference statements)

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“…[8][9][10] Studies have demonstrated efficacy of ondansetron in children with mild to moderate dehydration who had initially failed ORT 9,11 and in those with multiple episodes of vomiting prior to ED presentation. 12 Although now administered to more than 50% of children with AGE in US EDs, 13 its administration is not recommended in guidelines endorsed by the American Academy of Pediatrics. 14 There are concerns that indiscriminate use may result in increased ED revisits, rates of misdiagnosis, 15 and health care costs.…”

mentioning

confidence: 99%

Impact of Increasing Ondansetron Use on Clinical Outcomes in Children With Gastroenteritis

et al. 2014

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Impact of Increasing Ondansetron Use on Clinical Outcomes in Children With Gastroenteritis

et al. 2014

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“…[6][7][8][9] Emergency physicians (EPs) have subsequently begun using this more expensive class of medication. Two trials in pediatric ED patients found ondansetron to be effective compared to placebo, 10,11 and one trial found it superior to intravenous (IV) hydration with or without dexamethasone. 12 To our knowledge, ondansetron has not been previously studied in the adult ED population.…”

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confidence: 99%

Ondansetron versus Promethazine to Treat Acute Undifferentiated Nausea in the Emergency Department: A Randomized, Double‐blind, Noninferiority Trial

Braude

Crandall

2008

Academic Emergency Medicine

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Objectives: The authors sought to compare ondansetron and promethazine among emergency department (ED) patients with undifferentiated nausea. The hypothesis was that ondansetron was not inferior to promethazine and that rates of adverse effects were similar.Methods: This was a randomized double-blind noninferiority clinical trial conducted in an urban academic ED. A convenience sample of nonpregnant adults with at least 40 mm of self-reported nausea measured on a 100-mm visual analog scale (VAS) were enrolled. Patients who had already received more than 1 L of intravenous fluid or an antiemetic agent were excluded. Subjects were block-randomized in groups of 10 to either 4 mg of ondansetron or 25 mg of promethazine delivered intravenously. The primary outcome was change in nausea over 30 minutes. The authors used a 15-mm margin of noninferiority. Secondary endpoints included changes in anxiety, sedation, and other adverse effects. Analyses included t-tests, tests for proportions, and 95% confidence intervals (CIs).Results: A total of 120 subjects completed the study, 60 in each arm. Baseline nausea, anxiety, and sedation scores were similar. Ondansetron and promethazine reduced nausea similarly (ondansetron )34 mm, promethazine )36 mm; difference )2 mm; 95% CI = )13 to 8 mm). The reduction in anxiety was similar (ondansetron )13 mm, promethazine )14 mm; difference )1 mm; 95% CI = )10 to 10 mm). Promethazine was associated with significantly more sedation than ondansetron (ondansetron 5 mm, promethazine 19 mm; difference 14 mm; 95% CI = 5 to 24 mm). There were no cases of akathisia in the ondansetron group and 2 cases in the promethazine group.Conclusions: Promethazine and ondansetron have similar efficacy in reducing nausea among ED patients. Change in anxiety was similar, but promethazine was associated with greater sedation.ACADEMIC EMERGENCY MEDICINE 2008; 15:209-215 ª

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“…(25)(26)(27) It has also been useful in the setting of anaesthesia. (17) However, its use in preventing emesis following ketamine sedation has seen mixed views.…”

Section: Discussionmentioning

confidence: 99%

Predictors of emesis in children undergoing procedural sedation with intramuscular ketamine in a paediatric emergency department

Suryaprakash

Tham

2017

smedj

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A randomized clinical trial comparing oral ondansetron with placebo in children with vomiting from acute gastroenteritis

Cited by 149 publications

References 23 publications

Impact of Increasing Ondansetron Use on Clinical Outcomes in Children With Gastroenteritis

Impact of Increasing Ondansetron Use on Clinical Outcomes in Children With Gastroenteritis

Ondansetron versus Promethazine to Treat Acute Undifferentiated Nausea in the Emergency Department: A Randomized, Double‐blind, Noninferiority Trial

Predictors of emesis in children undergoing procedural sedation with intramuscular ketamine in a paediatric emergency department

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