Prophylactic use of ondansetron for emesis after craniofacial operations in children

Children who undergo craniofacial operations are especially at risk of post operative nausea and vomiting. These operations are more complex than the c raniotomies for resective procedures. Postoperative vomiting is a common oc currence that can delay recovery and result in cerebrospinal fluid leak aci d fistula formation in these patients. Ondansetron, a selective serotonergi c antagonist, is effective in reducing postoperative nausea and vomiting in several high-risk populations. In a randomized, double-blind, placebo-cont rolled study, the authors compared the prophylactic use of intravenous onda nsetron 0.15 mg/kg with induction of anesthesia versus a placebo of normal saline 0.3 ml/kg with induction. A second dose was given 8 hours after the first dose. After surgery, episodes of vomiting were recorded separately in 0 to 2 hours, 2 to 6 hours, 6 to 12 hours, 12 to 24 hours, and 24 to 48 ho urs. Postoperative vomiting is significantly reduced in the ondansetron gro up compared with the placebo group (P = 0.000258). Ondansetron is effective in the prevention of postoperative vomiting in the pediatric population un dergoing craniofacial operations.