Effects of Ondansetron in the Prevention of Postoperative Nausea and Vomiting in Children

Ummenhofer, Wolfgang; Frei, Franz J.; Urwyler, Albert; Kern, Christian; Drewe, Jürgen

doi:10.1097/00000542-199410000-00006

Cited by 72 publications

(39 citation statements)

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“…In a previous report [18], analgesic requirement was greater in the ondansetron group as compared to placebo and this was attributed to an anti-analgesic effect of ondansetron. Our findings were of a similar analgesic requirement and were in agreement with the reported data of Ummenhoffer et al [6].…”

Section: Discussionsupporting

confidence: 94%

“…In agreement with reported data [6], the incidence of postoperative emesis increased with age in all the groups. The need for postoperative analgesic therapy with indomethacin was similar in all three groups.…”

Section: Discussionsupporting

confidence: 92%

“…Recent studies [18,19] Forum Anaesthesia, 1997, 52, 489-500 ............................................................................................................................................................................................................................................ Ondansetron had been shown to be effective in the prevention of postoperative emesis following strabismus surgery [20,21] as well as other surgical procedures such as tonsillectomy and gynaecological laparoscopy [6,18,22,23]. In our study, ondansetron was more effective than metoclopramide in controlling the severity of vomiting and decreasing the overall incidence of postoperative emesis.…”

Section: Discussionmentioning

confidence: 99%

“…The antiemetics commonly used at present (metoclopramide, droperidol, promethazine) have limited efficacy in postoperative nausea and vomiting and are associated with side-effects such as sedation and extrapyramidal signs. Recently, ondansetron, a potent and selective 5-HT 3 receptor antagonist, has been shown to be effective in the prevention of chemotherapy-and radiotherapyinduced nausea and vomiting [5] as well as postoperative emesis in children [6]. In this study, we have compared the prophylactic anti-emetic efficacy of ondansetron with metoclopramide for the prevention of postoperative emesis in children undergoing elective strabismus surgery.…”

mentioning

confidence: 99%

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Efficacy of ondansetron and metoclopramide for preventing postoperative emesis following strabismus surgery in children

Shende

Mandal

1997

Anaesthesia

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SummaryA double-blind, randomised, placebo-controlled trial was conducted to compare the efficacy of metoclopramide with the 5-HT 3 antagonist, ondansetron, for the prevention of postoperative emesis in children undergoing elective strabismus surgery. None of the children received any premedication and a similar anaesthetic technique was used for all. Ondansetron 0.15 mg.kg ÿ 1 , metoclopramide 0.25 mg.kg ÿ 1 or saline placebo were administered following intravenous catheter placement. Episodes of emesis were recorded for the first 24 h for the intervals of 0-2, 2-6 and 6-24 h. The incidence of emesis in the first 24 h was observed to be 71.7% in the placebo group, 34.4% in the ondansetron group (p < 0.001) and 61.4% in the metoclopramide group (p = NS). The severity of vomiting was less in the ondansetron group as compared with metoclopramide (p < 0.01) and placebo (p < 0.001). Recovery room scores were comparable in all the groups. No serious side-effects were observed in the ondansetron group. We conclude that prophylactic ondansetron is effective and superior to metoclopramide in the prevention of postoperative emesis in children following elective strabismus surgery.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Efficacy of ondansetron and metoclopramide for preventing postoperative emesis following strabismus surgery in children

Shende

Mandal

1997

Anaesthesia

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“…The overall incidence of PONV was also relatively low, even in the case of tonsillectomy (31% compared with up to 70-80% in some studies). However, as the occurrence of PONV in hospital was the most significant factor to predict PONVat home, we recommend that all children who have emetic symptoms in hospital should be given effective, longacting anti-emetic medication, with minimal side-effects, such as a 5HT 3 receptor antagonist [24,25]. Prophylactic administration of ondansentron has been effective in high-risk children and it has reduced the resources needed to manage PONV [26].…”

Section: Nausea and Vomitingmentioning

confidence: 99%

Postoperative symptoms at home following day‐case surgery in children: a multicentre survey of 551 children

et al. 1997

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SummaryThe incidence and duration of postoperative symptoms in children at home following day-case anaesthesia and surgery was evaluated using a questionnaire completed by parents of 551 children aged 4 months to 13.4 years (mean 3.8 years). They also evaluated the instructions given in hospital for care at home. The incidence of all symptoms was highest at home on the day of the operation. No postoperative symptoms were reported in 79 (14%) children. The incidence of pain was 56% and the only significant predictor was the type of operation, tonsillectomy being the most problematic (mild pain in 38% and severe in 25%; pain lasted 7 days or longer in 33%). Analgesics were given to 78% of all the children reported to have pain on the day of the operation, to 60% the next day and later to 58%; 19 (3%) children were given more than two doses per day. The instructions given in hospital for the treatment of pain were considered inadequate by 12% of parents. Postoperative nausea and vomiting occurred in 13% of children. Predictors by multiple stepwise logistic regression analysis were emetic symptoms in hospital, pain at home, age > 5 years and administration of postoperative opioid (pethidine or fentanyl). Opioid given during anaesthesia (fentanyl or alfentanil) did not increase the incidence. Emetic symptoms were most common after tonsillectomy (31%). The highest incidences of emetic symptoms (37%), sedation (96%) and dizziness (41%) occurred in children who had been given fentanyl for postoperative pain. Undertreatment of nausea in hospital was evident as only two children had received anti-emetics, even though 61 were reported to have emetic symptoms. Administration of effective anti-emetics should be encouraged, as emetic symptoms in hospital were the most significant predictor of nausea and vomiting at home. Treatment of pain at home and instructions for treatment of pain need to be improved.

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Drugs for preventing postoperative nausea and vomiting

Carlisle

Stevenson²

2006

Cochrane Database of Systematic Reviews

227

133

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Either nausea or vomiting is reported to affect, at most, 80 out of 100 people after surgery. If all 100 of these people are given one of the listed drugs, about 28 would benefit and 72 would not. Nausea and vomiting are usually less common and, therefore, drugs are less useful. For 100 people, of whom 30 would vomit or feel sick after surgery if given placebo, 10 people would benefit from a drug and 90 would not. Between one to five patients out of every 100 people may experience a mild side effect, such as sedation or headache, when given an antiemetic drug. Collaborative research should focus on determining whether antiemetic drugs cause more severe, probably rare, side effects. Further comparison of the antiemetic effect of one drug versus another is not a research priority.

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Effects of Ondansetron in the Prevention of Postoperative Nausea and Vomiting in Children

Cited by 72 publications

References 0 publications

Efficacy of ondansetron and metoclopramide for preventing postoperative emesis following strabismus surgery in children

Efficacy of ondansetron and metoclopramide for preventing postoperative emesis following strabismus surgery in children

Postoperative symptoms at home following day‐case surgery in children: a multicentre survey of 551 children

Drugs for preventing postoperative nausea and vomiting

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