ANTICHOLINERGIC PROPHYLAXIS DOES NOT PREVENT EMESIS FOLLOWING STRABISMUS SURGERY IN CHILDREN

One hundred and twenty-one children were studied in this prospective, randomized double-blind, placebo-controlled comparison of the effectiv eness of anticholinergic prophylaxis for the prevention of emetic symp toms following strabismus surgery. The children were allocated to thre e groups, to receive placebo (n = 40), glycopyrrolate (n = 40) or atro pine (n = 41). The incidence of intraoperative oculocardiac reflex (OC R) and of postoperative emetic symptoms for 24 h was recorded. The inc idence of OCR was 55% in the placebo group compared with 5% and 2% in the glycopyrrolate and atropine groups respectively (P < 0.05). Thirty percent (12/40) of patients in the placebo group, 25% (10/40) in the glycopyrrolate group, and 22% (9/41) in the atropine group experienced nausea and/or vomiting (difference not significant). It is concluded that prophylactic administration of anticholinergic agents during stra bismus surgery in children despite being effective against the occurre nce of the oculocardiac reflex, does not reduce the incidence of emeti c symptoms.