The dose-response relationship of ondansetron in preventing postoperative emesis in pediatric patients undergoing ambulatory surgery

M. F. Watcha, P. J. Bras, G. D. Cieslak, J. H. Pennant

Research output: Contribution to journalArticle

60 Scopus citations

Abstract

Background: Postoperative nausea and vomiting is a distressing anesthetic complication that may delay discharge after ambulatory surgery. Effective prophylaxis for postoperative nausea and vomiting can be achieved in adults with lower doses of ondansetron, a 5-hydroxytryptamine subtype 3 receptor antagonist, compared with chemothera-induced emesis. However, the doses of ondansetron used in preventing postoperative nausea and vomiting in children are based on data from chemotherapy-induced emesis. The dose-related efficacy of intravenous ondansetron in the prophylaxis of post-operative emesis in the pediatric outpatient population was Methods: In a double-blind, randomized placebo-controlled study, 130 patients (mean age 5.7 + 3.4 yr) received placebo, 10, 50, or 100 μg/kg ondansetron during a standardized anesthetic. Episodes of postoperative vomiting or retching were recorded. Results: Intravenous ondansetron in a dose of 50 μg/kg was more effective than placebo or a dose of 10 μg/kg in controlling the incidence and frequency of emesis in the hospital and during the first 24 postoperative hours. Increasing the dose of ondansetron to 100 μg/kg intravenously did not significantly reduce the incidence or frequency of emesis compared to 50 μg/kg intravenously. Conclusions: Intravenous ondansetron in a dose 50 μg/kg is as effective as larger doses for the prophylaxis of emesis in children undergoing surgical procedures known to be associated with an increased risk for postoperative nausea and vomiting.

Original languageEnglish (US)
Pages (from-to)47-52
Number of pages6
JournalAnesthesiology
Volume82
Issue number1
DOIs
StatePublished - Feb 3 1995

Keywords

  • Anesthesia: ambulatory; pediatrics
  • Antiemetics: ondansetron
  • Complications: postoperative vomiting

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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