ORAL ONDANSETRON DECREASES VOMITING AFTER TONSILLECTOMY IN CHILDREN

Vomiting is a common, unpleasant aftermath of tonsillectomy in childre n. Intraoperative intravenous ondansetron (OND) reduces vomiting after this operation. Our double-blind, placebo-controlled randomized inves tigation studied the effect of the oral form of OND on vomiting after outpatient tonsillectomy in children. We studied 233 healthy children age 2-14 yr undergoing elective tonsillectomy. Subjects were given pla cebo (PLAC) or OND 0.1 mg . kg(-1) rounded off to the nearest 2 mg one hr before surgery. Anaesthesia was induced with either propofol or ha lothane/N2O. Vecuronium 0.1 mg . kg(-1) was administered al the discre tion of the anaesthetist. Anaesthesia was maintained with halothane/N2 O, 50 mu g . kg(-1) midazolam iv and 1-1.5 mg . kg(-1) codeine im. At the end of surgery, residual neuromuscular blockade was as reversed wi th neostigmine and atropine. All episodes of in-hospital emesis were r ecorded by nursing staff Rescue antiemetics in the hospital were 1 mg . kg(-1) dimenhydrinate iv for vomiting X 2 and 50 mu g . kg(-1) drope ridol iv for vomiting X 4. Parents kept a diary of emesis after discha rge. Postoperative pain was treated with morphine, codeine and/or acet aminophen. The two groups were similar with respect to demographic dat a, induction technique and anaesthesia rime. Oral OND (n = 109) reduce d postoperative emesis from 54% to 39%, P < 0.05. This effect was most dramatic in-hospital where 10% of the OND-patiene and 30% of the PLAC -group vomited, P < 0.05. The OND-subjects required fewer er rescue an tiemetics, 7% vs 17%, P < 0.05. In conclusion, oral ondansetron decrea sed the incidence of vomiting after outpatient tonsillectomy in childr en.