Gastric residual volume in children: a study comparing efficiency of erythromycin and metoclopramide as prokinetic agents

Metoclopramide may be used to stimulate gastric emptying when anaesthetizin g children for emergency operations. Unfortunately, metoclopramide is assoc iated with extrapyramidal side effects. Erythromycin, a motilin receptor ag onist, is a prokinetic agent but its use has been little investigated in ch ildren. This randomized double-blind study compared the effects of premedic ation with oral metoclopramide 0.15 mg kg(-1) or erythromycin 1 mg kg(-1) o n gastric emptying in 80 children undergoing tonsillectomy. Pre-operative f luids, premedication and anaesthetic technique were standardized and gastri c volume was measured with an orogastric tube. Postoperative nausea and vom iting was recorded. Metoclopramide and erythromycin produced similar gastri c volumes (0.29 and 0.24 ml kg(-1)) and there was no difference in post-ope rative vomiting, in the erythromycin group there were more patients with ne gative aspirates (45.9%) than in the metoclopramide group (35.1%), but the difference was nor, statistically significant. These results indicate that erythromycin may be as effective as metoclopramide as a prokinetic agent.