A DOUBLE-BLIND COMPARISON OF DROPERIDOL AND ONDANSETRON FOR PREVENTION OF EMESIS IN CHILDREN UNDERGOING ORTHOPEDIC-SURGERY

Emesis is common in the postoperative period following epidural opioid and general anaesthesia. Eighty patients ages two to 14 years schedul ed for major orthopaedic surgery were enrolled in a randomized, double -blind study to compare the prophylactic effects of ondansetron, drope ridol and a placebo for the prevention of postoperative emesis. Each c hild was assigned at random to one of the four treatment groups: ondan setron 100 mu g.kg(-1), ondansetron 50 mu g.kg(-1), droperidol 60 mu g .kg(-1) and saline control. Drugs were administered intravenously afte r the induction of anaesthesia. Anaesthesia was supplemented with epid ural fentanyl, given as an infusion of 1 mu g.kg(-1) and continued for postoperative pain control. The incidence of vomiting in the immediat e postoperative period was 25% with ondansetron (100 mu g.kg(-1)), 40% with ondansetron (50 mu g.kg(-1)) and droperidol and 70% with the con trol group. in the next 48 h the incidence of emesis increased to 30% for ondansetron (100 mu g.kg(-1)), 55% with ondansetron (50 mu g.kg(-1 )), 65% with droperidol and 85% for the control group. Those patients who had multiple emesis necessitating a second dose of the same drug t reatment showed no difference in the incidence of emesis relative to t he control group. Ondansetron (50 mu g.kg(-1)) and droperidol groups h ad lower incidence of PONV compared to the control group. The ondanset ron (100 mu g.kg(-1)) group had a significant decrease in the incidenc e of emesis. We conclude that the prophylactic administration of ondan setron (100 mu g.kg(-1)) is more effective than droperidol and ondanse tron (50 mu g.kg(-1)) and superior to saline (P<0.02) for the preventi on of emesis before epidural opioid and general anaesthesia.