DIMENHYDRINATE DECREASES VOMITING AFTER STRABISMUS SURGERY IN CHILDREN

Dimenhydrinate, a H-1-receptor antagonist, has been used to both preve nt and treat postoperative vomiting (POV) in children for several deca des. However, its effectiveness for POV after strabismus surgery remai ns anecdotal. This study was designed to determine the effectiveness a nd side effects of dimenhydrinate for the prevention of POV in childre n after strabismus surgery. Eighty ASA physical status I or II childre n, ages 1-12 yr inclusive, who were undergoing strabismus surgery, wer e prospectively and randomly allocated to receive either dimenhydrinat e 0.5 mg/kg intravenously (n = 40) or placebo (n = 40) at induction of anesthesia. The incidence of POV and the times to arousal and dischar ge from the recovery room and hospital were recorded postoperatively i n a double-blinded manner. For 24 h after discharge from the hospital, all emetic episodes and medications given were recorded by the parent s. Demographic data did not differ between the groups. Children who re ceived dimenhydrinate had significantly less POV both in hospital (10% ) and overall (30%) than those who received placebo (in-hospital 38%, P < 0.008; overall 65%, P < 0.003). The times to arousal and discharge from the hospital did not differ between the two groups. Dimenhydrina te (0.5 mg/kg) is an effective, safe, and inexpensive antiemetic in ch ildren undergoing strabismus surgery. It significantly reduces the inc idence of vomiting for 24 h postoperatively and is not associated with prolonged sedation or other adverse effects.