• Muhammad Shakeel, Aaron Trinidade, Ahmed Al-Adhami, Imran Khan, Mrinal Supriya, and Haytham Kubba.
• Department of Otolaryngology-Head and Neck Surgery, Aberdeen Royal Infirmary, University of Aberdeen, Aberdeen, AB25 2ZN, Scotland. drshakeel@doctors.org.uk
• J Otolaryngol Head N. 2012 Feb 1;41(1):35-40.

ObjectiveTo study the effect of intraoperative ondansetron and dexamethasone on postoperative vomiting in children undergoing tonsillectomy, adenotonsillectomy, or adenoidectomy.Study DesignRetrospective chart review.SettingAcademic tertiary care referral centre in the west of Scotland.Subjects And MethodsA retrospective chart review was conducted on 432 children admitted to our institute between 2004 and 2006. Of these, 285 (66%) patients underwent a tonsillectomy, 50 (11.6%) an adenotonsillectomy, and 97 (22.4%) an adenoidectomy. There was an equal gender distribution, with a mean age of 7.4 years (interquartile range 4.6-10.0). Patients were divided into four groups: group 1 received ondansetron plus dexamethasone (n  =  64, 14.7%), group 2 received ondansetron only (n  =  189, 43.6%), group 3 received dexamethasone only (n  =  17, 3.9%), and group 4 did not receive ondansetron or dexamethasone (n  =  162, 37.4%).ResultsOverall, 98 (22.7%) patients experienced postoperative vomiting (5 at the time of recovery and 93 on the ward). Patients in group 1 had a significantly lower incidence of postoperative vomiting than those in group 2 (10.9% vs 22.8%, p  =  .04) and group 4 (10.9% vs 27.2%, p < .01). The incidence of postoperative vomiting was also lower in group 1 than in group 3, but this did not reach statistical significance (10.9% vs 23.5%, p  =  .18).ConclusionThe combined intraoperative use of ondansetron and dexamethasone appears to be superior to no antiemetic or ondansetron alone in reducing the incidence of vomiting in children undergoing adenotonsillar surgery.

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