ONDANSETRON IS A BETTER PROPHYLACTIC ANTIEMETIC THAN DROPERIDOL FOR TONSILLECTOMY IN CHILDREN

Both intravenous ondansetron (OND) and droperidol (DROP) have been obs erved to reduce vomiting after tonsillectomy in children. This randomi zed, double-blind investigation compared the effect of OND and DROP on vomiting after out-patient tonsillectomy in 276 healthy children age 2-12 yr. All subjects received a standardized anaesthetic, which consi sted of induction with either propofol or halothane/N2O, vecuronium 0. 1 mg . kg(-1) on an as needed basis, maintenance with hal othane/N2O, midazolam and codeine, and reversal of neuromuscular blockade with neo stigmine and atropine on an as needed basis. Subjects were given eithe r OND 150 mu g . kg(-1) or DROP 50 mu g . kg(-1) iv after induction of anaesthesia. Rescue antiemetics in the hospital were administered to patients who vomited X 2 and X 4, respectively. Postoperative pain was treated with morphine, codeine and/or acetaminophen. For 24 hr follow ing surgery, emesis was recorded by nursing staff while subjects were in hospital, and by parents following discharge from hospital. The two groups were similar with respect to demographic data, induction techn ique and anaesthesia time. The frequency of in-hospital emesis was 16% in the OND-patients and 30% in the DROP-group, P < 0.05. The OND-subj ects required fewer rescue antiemetics, 5% vs 13%, P < 0.05. The overa ll incidence of emesis was 45% in the OND-group and 57% in the DROP-gr oup, P < 0.05. In conclusion, ondansetron was a superior prophylactic antiemetic for tonsillectomy in children when compared to droperidol.