Postoperative vomiting in children

Morrison, Christa; Wilmshurst, Sally

doi:10.1016/j.bjae.2019.05.006

Cited by 6 publications

(7 citation statements)

References 23 publications

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“…Other drugs such as neurokinin 1 (NK1) receptor antagonists (e.g., aprepitant and fosaprepitant) have been successfully tried in post-chemotherapy vomiting with favorable results. Data support their safety in the pediatric population (14), and there is evidence of similar effects to those of ondansetron in the prevention of POV in adults (15). On the other hand, non-pharmacological treatments like P6 stimulation with different acupuncture techniques have shown to reduce POV substantially, with effects similar to those of some antiemetics like ondansetron, droperidol and metoclopramide (11).…”

Section: ¿Qué Aporta Este Estudio De Nuevo?mentioning

confidence: 98%

Incidence of postoperative vomiting in pediatric population undergoing anesthesia: a prospective cohort study

Jaimes-Daza

Alarcón-Tarazona

Duarte-Villamizar

et al. 2020

Colomb. j. anesthesiol.

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Introduction: Postoperative nausea and vomiting are frequent adverse effects of anesthesia and surgery. Impact is greater in pediatric populations compared to adults and the reported incidences are heterogeneous. Objective: To describe the incidence of postoperative vomiting in a pediatric population and to identify associated risk factors. Materials and methods: This prospective cohort study included 190 children aged 3 to 12 years undergoing surgery and anesthesia in a maternal and child health clinic in Bucaramanga (Colombia). The main outcome variable was postoperative vomiting. Data were analyzed using bivariate, multivariate analysis and logistic regression to assess the associated risk factors. Results: The overall incidence of postoperative vomiting was 18.95% (95% CI: 13.32 - 24.57), with a higher incidence at home vs. hospital (12.63% vs. 9.47%). After adjustment, associated risk factors were anesthesia time longer than 45 minutes (OR: 2.33; 95% CI: 1.10-4.90) and postoperative use of opioids (OR: 4.17; 95% IC: 1.65-10.5). The incidence of postoperative vomiting was higher in patients who underwent emergency surgery. Conclusion: This is the first study in Colombia that evaluates the incidence of postoperative vomiting in children. The incidence in our pediatric population is within the ranges reported worldwide. Associated risk factors were anesthesia time longer than 45 minutes and postoperative use of opioids. Further research is required in order to study emergency surgery as a potential risk factor.

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Section: ¿Qué Aporta Este Estudio De Nuevo?mentioning

confidence: 98%

Incidence of postoperative vomiting in pediatric population undergoing anesthesia: a prospective cohort study

Jaimes-Daza

Alarcón-Tarazona

Duarte-Villamizar

et al. 2020

Colomb. j. anesthesiol.

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“…Especially children at least 3 years of age are at risk of PONV. Thus, knowledge of available (pharmacologic) countermeasures is key for adequate care in this vulnerable patient group [21]. As in adults, use of combination therapy is recommended for children with one or more risk factors, and thus virtually for all children.…”

Section: Drugs For Postoperative Nausea and Vomiting Prophylaxis In C...mentioning

confidence: 99%

Drugs in anesthesia: preventing postoperative nausea and vomiting

Schlesinger

Weibel²,

Meybohm³

et al. 2021

Current Opinion in Anaesthesiology

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Purpose of reviewPostoperative nausea and vomiting (PONV) continues to be a burden for patients, medical staff and healthcare facilities because of inadequate adherence to available recommendations. This review gives an overview on recent recommendations, new evidence and remaining issues in the field of PONV management. Recent findingsA wide range of drugs is available for the management of PONV including corticosteroids, 5-HT 3antagonists, dopamine-antagonists, neurokinin-receptor-1 (NK 1 )-antagonists, antihistamines and anticholinergics. The updated PONV guidelines from 2020 recommend a universal multimodal strategy for PONV prophylaxis, which is an important paradigm shift to improve implementation of the existing evidence. A recent Cochrane network meta-analysis ranked single drugs and drug combinations for PONV prophylaxis in terms of efficacy and safety. Notably, NK 1 -antagonists and new 5-HT 3 -antagonists ranged among the most effective drugs. However, safety data on antiemetics are generally scarce. SummaryNumerous drug (combinations) and strategies are available for PONV management. New and very effective (single) drugs could result in a simplification compared with a combination of several drugs, and thus lead to better implementation. Keywords antiemetics, enhanced recovery after surgery, postanesthetic care, postoperative nausea and vomiting PONV is a multifactorial phenomenon and accordingly, a broad spectrum of different drug classes

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“…Predictors for KAV include increasing age (peak incidence at 12 years), IM route of administration and unusually high intravenous (IV) dose (initial dose of ≥2.5 mg/kg or a total dose of ≥5.0 mg/kg) 12 . KAV can be distressing for both the patient and family, 18 potentially decreasing overall satisfaction with care. Reduction in the incidence of KAV could improve patient experience 19 and satisfaction.…”

Section: Introductionmentioning

confidence: 99%

Review article: Efficacy of prophylactic ondansetron versus placebo or control in reducing vomiting in children undergoing ketamine procedural sedation in the emergency department: A systematic review and meta‐analysis

Hudson,

Wong,

Durkin

et al. 2024

Emerg Medicine Australasia

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Ketamine is commonly used for procedural sedation anaesthesia in paediatric patients undergoing painful procedures in the ED. Ketamine's safety profile is excellent, but ketamine‐associated vomiting (KAV) is common. Routine ondansetron prophylaxis could reduce KAV incidence. This literature review evaluated the efficacy of prophylactic ondansetron in reducing KAV incidence. A systematic literature review was performed on databases and trial registries on 14 January 2023 to identify randomised controlled trials. The primary outcome was reduction in KAV incidence, for any route of prophylactic ondansetron, in ED and up to 24 h post‐discharge. ED length of stay, parental satisfaction and time to resumption of normal diet were secondary outcomes. Data analysis was performed using Revman 5.3. Meta‐analysis was performed using random effects modelling. Risk of bias was assessed using the Cochrane Risk‐of‐Bias 2 tool. Evidence quality was assessed using Grading of Recommendation, Assessment Development and Evaluation methodology. Five trials with 920 participants met the eligibility criteria. Prophylactic ondansetron resulted in a reduction in KAV incidence overall odds ratio of 0.51 (95% confidence interval: 0.36–0.73). Intravenous and intramuscular prophylactic ondansetron showed benefit whereas the effect of oral administration was unclear. There was no difference between groups for secondary outcomes overall. The quality of evidence was deemed to be low overall because of high risk of bias and imprecision in outcome measures. This review found low to moderate certainty evidence that prophylactic ondansetron reduces KAV incidence. Methodologically rigorous research, with appropriately timed prophylactic ondansetron based on the route of administration, would further elucidate prophylactic oral ondansetron's efficacy.

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Postoperative vomiting in children

Abstract: Identify children at risk of postoperative vomiting (POV).Apply a risk stratification strategy to distinguish 'high-risk' children. Communicate risk and treatment strategies appropriately. Provide effective prophylaxis and treatment of POV in children.

Cited by 6 publications

References 23 publications

Incidence of postoperative vomiting in pediatric population undergoing anesthesia: a prospective cohort study

Incidence of postoperative vomiting in pediatric population undergoing anesthesia: a prospective cohort study

Drugs in anesthesia: preventing postoperative nausea and vomiting

Review article: Efficacy of prophylactic ondansetron versus placebo or control in reducing vomiting in children undergoing ketamine procedural sedation in the emergency department: A systematic review and meta‐analysis

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