Reduction of postoperative nausea and vomiting by dimenhydrinate suppositories after strabismus surgery in children

Although dimenhydrinate has been used for treatment and prevention of posto perative nausea and vomiting (PONV) since the fifties, there have been few controlled studies about its efficacy. We performed a double-blinded study of 301 children aged 4 to 10 yr who underwent strabismus surgery. Preanesth etic medication with midazolam (0.5 mg/kg) as well as application of either dimenhydrinate suppositories or a placebo preparation was performed 30 min before the induction of anesthesia. Anesthesia was induced with thiopenton e (5-10 mg/kg) and vecuronium (0.1 mg/kg) and maintained with halothane (1% -2%) in N2O/O-2 (65%/35%). The incidence of PONV, requirements for rescue d imenhydrinate, and time to recovery were recorded. The overall incidence of PONV was 60.1% in the placebo group and 30.7% in the dimenhydrinate group. In the dimenhydrinate group, children had to be observed in the recovery r oom significantly longer than those in the placebo group. Children having r eceived dimenhydrinate were discharged from the recovery room with lower ar ousal scores. We conclude that the rectal administration of dimenhydrinate is effective for the prevention of PONV, although the sedative effect may r equire longer postoperative monitoring. Implications: We performed a double -blinded, randomized study to investigate the effects of prophylactic recta l dimenhydrinate application on postoperative nausea and vomiting in childr en undergoing strabismus surgery. In comparison with placebo, dimenhydrinat e reduced the incidence of postoperative vomiting from 60.1% to 30.7%.