• F N Stene, R E Seay, L A Young, L E Bohnsack, and B C Bostrom.
• Department of Anesthesiology, Children's Health Care-Minneapolis, MN 55404, USA.
• J Clin Anesth. 1996 Nov 1;8(7):540-4.

Study ObjectiveTo compare the antimetic efficacy of prophylactic ondansetron, metoclopramide, and placebo for prevention of postoperative vomiting in pediatric tonsillectomy or adenotonsillectomy patients.DesignProspective, randomized, double-blind, placebo controlled study.SettingChildren's hospital.Patients132 ASA status I and II children, ages 2 to 12 years, undergoing tonsillectomy or adenotonsillectomy.InterventionsPatients received intravenous (IV) melodopramide 0.25 mg/kg, IV on dansetron 0.15 mg/kg, or IV saline placebo after induction of standardized halothane, nitrous oxide, and oxygen anesthesia. Muscle relaxants and their antagonists were allowed. Patients received postoperative analgesics as needed.Measurements And Main ResultsIncidence of postoperative vomiting, time of vomitting onset, and hospital length of stay (LOS) were measured. Patients who were admitted were excluded from LOS analysis. The postoperative incidence of vomiting was 54% for patients receiving metoclopramide, 26% for patients receiving ondansetron, and 69% for the placebo group. These differences were significant for ondansetron versus metoclopramide (p = 0.008) and placebo (p = 0.001). The mean (SD) LOS was significantly shorter for patients not vomiting 488 (88) minutes for vomiters versus 435 (65) minutes for non-vomiters.ConclusionsProphylactic ondansetron is more effective than metoclopramide or placebo for the prevention of vomiting after tonsillectomy or adenotonsillectomy. Patients who do not vomit postoperatively have shorter LOS.

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