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Ondansetron reduces nausea and vomiting after paediatric adenotonsillectomy.

Author(s): Morton NS, Camu F, Dorman T, Knudsen KE, Kvalsvik O, Nellgard P, Saint-Maurice CP, Wilhelm W, Cohen LA

Affiliation(s): Department of Paediatric Anaesthesia and Intensive Care, Royal Hospital for Sick Children, Yorkhill NHS Trust, Glasgow, Scotland, UK.

Publication date & source: 1997, Paediatr Anaesth., 7(1):37-45.

Publication type: Clinical Trial; Multicenter Study; Randomized Controlled Trial

The efficacy, safety and resource implications of a single intravenous dose of ondansetron (0.1 mg.kg-1, maximum 4 mg) were assessed in a multinational, multicentre, randomized, double-blind, placebo-controlled trial of 427 children aged 1-12 years, undergoing tonsillectomy with/without adenoidectomy. Emesis (retching and/or vomiting) and nausea were analysed separately. Significantly more ondansetron-treated children had no episodes of emesis (127/212 (60%) vs 100/215 (47%); P = 0.004) and experienced no postoperative nausea (135/211 (64%) vs 108/213 (51%); P = 0.004) in the first 24 h. Ondansetron also reduced the number of emetic episodes (P < 0.001), the time to the first emetic episode (P < 0.001) and overall nausea severity (P = 0.003). Significantly fewer ondansetron-treated children were rescued or withdrawn from the study (5% vs 10%; P = 0.042). Fewer ondansetron-treated patients required nursing intervention (34% vs 45%; P = 0.007) and the average intervention time was significantly shorter (4.6 vs 8.1 minutes; P = 0.001). Resources used to manage PONV were significantly reduced by ondansetron (43% vs 57%; P = 0.014).

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