The effect of preoperative low-dose ondansetron and dexamethasone on the immediate and delayed postoperative morbidity in children undergoing adenotonsillectomy

Luminiţa Cîmpeanu1, M. Chioreanu2
1. Compartimentul ATI, Clinica ORL Târgu Mureş
2. Clinica ATI Spitalul Clinic Judeţean Târgu Mureş

Abstract

Introduction. This study presents the effect of low-dose ondansetron (50 mg/kg) plus dexamethasone (150 mg/kg) on the incidence of postoperative vomiting and 24 hours recovery in children undergoing adenotonsillectomy.

Methods.
With a double-blind randomized design, we studied 100 children, 2-12 yr. of age, ASA I or II, undergoing adenotonsillectomy under general anesthesia. During inhalatory induction, half of the patients received placebo (saline) – P group, the other half received dexamethasone and ondansetron intravenously – OD group, the same volume. All episodes of vomiting, occurring as long as 24 hours after anesthesia, were recorded. The amount of fluids administered perioperatively, the pain treatment and the rescue antiemetic regimen were standardized.

Results.
The OD-group had a significantly lower incidence of vomiting in the first three postoperative hours 10% vs. 32% and also during the rest of the study period until 24 h (24% vs. 68%). Significantly fewer children in the P group had good to excellent oral intake during the two study periods.

Conclusions.
Low-dose ondansetron plus dexamethasone is an effective prophylactic antiemetic combination for children undergoing adenotonsillectomy. That combination also improves the oral intake after surgery.

Key words:
anaesthesia, pediatric; vomiting, incidence; vomiting, antiemetics

Jurnalul Român de Anestezie Terapie intensivă 2003 Vol.10 Nr.1, 11-16

Efectul combinaţiei ondansetron – dexametazonă asupra morbidităţii postoperatorii imediate şi tardive la copiii adeno-amigdalectomizaţi în anestezie generală