Rapid intravenous administration of ondansetron or metoclopramide is not associated with cardiovascular compromise in children

Rose, John B.; McCloskey, John

doi:10.1111/j.1460-9592.1995.tb00258.x

Cited by 11 publications

(2 citation statements)

References 14 publications

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“…infusion of ondansetron in children was not associated with changes in heart rate, arterial pressure or oxyhaemoglobin saturation. 79 Psychomotor and respiratory function were unaffected by ondansetron.…”

Section: Serotonin Receptor Antagonistsmentioning

confidence: 98%

Postoperative nausea and vomiting in paediatric patients

Rose

Watcha

1999

British Journal of Anaesthesia

191

126

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The past decade has witnessed the introduction of several significant innovations to combat POV, particularly the introduction of serotonin antagonists and the use of combinations of drugs for analgesia and control of POV. Based on current knowledge, the anaesthetic plan for a patient with a previous history of severe PONV and undergoing a procedure known to be associated with a high incidence of this problem should include premedication with a benzodiazepine and/or clonidine and the preferential use of regional anaesthetic techniques. If general anaesthesia is essential, anaesthetists should consider the use of propofol for both induction and maintenance of anaesthesia, together with avoidance of nitrous oxide, opioids and neuromuscular antagonists. Pain control is extremely important, and a peripheral regional block should be used if possible. A combination of prophylactic antiemetics such as dexamethasone, a 5-HT3 antagonist and an antiemetic of a different class (e.g. perphenazine or dimenhydrinate) should be administered. Non-pharmacological measures such as acupressure and suggestion should also be considered, together with nursing measures to avoid sudden movement from one position to another during the postoperative period. A quiet environment, adequate i.v. fluids and not forcing the patient to drink before discharge all contribute to decreased emesis. It is possible that the advent of a new class of antiemetic agents, the NKI antagonists, may have major effects on the incidence of this complication. Drugs in this group differ from other currently available drugs in having the ability to effectively block the emetic response to many stimuli in experimental animals. Postoperative vomiting remains a significant problem, resulting in patient suffering and prolonged recovery from anaesthesia. Our aim should be to eliminate this complication in all children who require surgery. It should not be considered merely as the 'big, little problem'.

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Section: Serotonin Receptor Antagonistsmentioning

confidence: 98%

Postoperative nausea and vomiting in paediatric patients

Rose

Watcha

1999

British Journal of Anaesthesia

191

126

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“…Anderson 2 2,6 Anderson 1 2,6 Barst 6 2 Carithers 8 2 Chhibber 11 2,6 Church 12 2 Cohn 13 2 Courtman 14 2 Culy 15 2 Dillier 17 5 Fujii 23 4 29 2 Fujii 31 2 Fujii 32 2 Fujii 22 4 Fujii 24 4 Fujii 26 2 Guida 36 2 Heatley 38 2 Hellier 39 2 Hengerer 40 2 Holt 41 2 Kanerva 44 2 Kearney 45 6 Kermode 46 2 Lawhorn 49 4 Lawhorn 48 3 Madadaki 51 5 Moiniche 52 2 Mukherjee 54 2,6 Nolan 55 2 O'Flaherty 56 6 Panarese 58 2 Pandit 59 6 Pappas 60 7 Patel 62 2 Roberts 64 2 Romsing 65 6 Rose 66 2 Rose 67 2 Shott 76 2 Splinter 86 4 Semple 73 2.6 Smith 77 2 Splinter 85 2 Splinter 83 2 Splinter 78 2 Splinter 81 2 Steward …”

Section: Table A1mentioning

confidence: 99%

Prophylaxis of postoperative vomiting in children undergoing tonsillectomy: a systematic review and meta-analysis

Bolton

Myles

Nolan

et al. 2006

British Journal of Anaesthesia

126

107

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Postoperative vomiting (POV) remains one of the commonest causes of significant morbidity after tonsillectomy in children. A variety of prophylactic anti-emetic interventions have been reported, but there has only been a limited systematic review in this patient group. A systematic search was performed by using Cochrane Controlled Trials Register, MEDLINE and EMBASE to identify double-blind, randomized, placebo-controlled trials of prophylactic anti-emetic interventions in children undergoing tonsillectomy, with or without adenoidectomy. The outcome of interest was POV in the first 24 h. Summary estimates of the effect of each prophylactic anti-emetic strategy were derived using fixed effect meta-analysis. Where appropriate, dose-response effects were estimated using logistic regression and 22 articles were identified. Good evidence was found for the prophylactic anti-emetic effect of dexamethasone [odds ratio (OR) 0.23, 95% CI 0.16-0.33], and the serotinergic antagonists ondansetron (OR 0.36, 95% CI 0.29-0.46), granisetron (OR 0.11, 95% CI 0.06-0.19), tropisetron (OR 0.15, 95% CI 0.06-0.35) and dolasetron (OR 0.25, 95% CI 0.1-0.59). Metoclopramide was also found to be efficacious (OR 0.51, 95% CI 0.34-0.77). There is not sufficient evidence to suggest that dimenhydrinate, perphenazine or droperidol, in the doses studied, are efficacious, nor were gastric aspiration or acupuncture. In conclusion, dexamethasone and the anti-serotinergic agents appear to be the most effective agents for the prophylaxis for POV in children undergoing tonsillectomy.

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