• M Goodarzi.
• Department of Anesthesis, Children's Hospital Los Angeles, CA 90027, USA.
• Paediatr Anaesth. 1998 Jan 1;8(4):325-9.

AbstractEmesis is common in the postoperative period following epidural opioid and general anaesthesia. Eighty patients ages two to 14 years scheduled for major orthopaedic surgery were enrolled in a randomized, double-blind study to compare the prophylactic effects of ondansetron, droperidol and a placebo for the prevention of postoperative emesis. Each child was assigned at random to one of the four treatment groups: ondansetron 100 micrograms.kg-1, ondansetron 50 micrograms.kg-1, droperidol 60 micrograms.kg-1 and saline control. Drugs were administered intravenously after the induction of anaesthesia. Anaesthesia was supplemented with epidural fentanyl, given as an infusion of 1 microgram.kg-1 and continued for postoperative pain control. The incidence of vomiting in the immediate postoperative period was 25% with ondansetron (100 micrograms.kg-1), 40% with ondansetron (50 micrograms.kg-1) and droperidol and 70% with the control group. In the next 48 h the incidence of emesis increased to 30% for ondansetron (100 micrograms.kg-1), 55% with ondansetron (50 micrograms.kg-1), 65% with droperidol and 85% for the control group. Those patients who had multiple emesis necessitating a second dose of the same drug treatment showed no difference in the incidence of emesis relative to the control group. Ondansetron (50 micrograms.kg-1) and droperidol groups had lower incidence of PONV compared to the control group. The ondansetron (100 micrograms.kg-1) group had a significant decrease in the incidence of emesis. We conclude that the prophylactic administration of ondansetron (100 micrograms.kg-1) is more effective than droperidol and ondansetron (50 micrograms.kg-1) and superior to saline (P < 0.02) for the prevention of emesis before epidural opioid and general anaesthesia.

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