VOMITING AFTER STRABISMUS SURGERY IN CHILDREN - ONDANSETRON VS PROPOFOL

Purpose: To compare the antiemetic efficacy and costs associated with two anaesthetic regimens in children undergoing strabismus surgery. On e regimen contained halothane, nitrous oxide and ondansetron, white th e other contained propofol and nitrous oxide. Methods: Three hundred c hildren aged 2-14 yr undergoing strabismus surgery were enrolled into this single-blind, randomized, stratified, blocked study with a balanc ed design. Anaesthesia was induced by inhalation with halothane/N2O/O- 2 (Group O) or with 2.5-3.5 mg.kg(-1) propofol + 0.5 mg.kg(-1) lidocai ne iv (Group P). Group O patients were administered 0.15 mg.kg(-1) ond ansetron (maximum dose 8 mg) iv and all patients received atropine 20 mu g.kg(-1) iv immediately after induction of anaesthesia. Anaesthesia was maintained with N2O and halothane (Group O) or N2O and propofol ( Group P). Patients were followed for 24 hr after their operation prima rily to assess the incidence of postoperative vomiting, For each case, the costs of the anaesthetic drugs administered and their associated intravenous administration tubing were determined. Drug costs were tho se prevailing at the study site at the time of the investigation. Fixe d costs, such as the cost of the anaesthetic equipment were not assess ed. Results: Groups were similar with respect to demographic data. The incidence of vomiting in both groups was 11% while in-hospital and 23 % after discharge. Each episode of in-hospital vomiting prolonged disc harge by 17+/-4 min, P < 0.001. Mean cost per case for anaesthetic dru gs was less in Group 0, 18 +/- 8 vs 21 +/- 10 CDN$, mean +/- SD, P < 0 .01. Conclusion: The two methods of antiemetic prophylaxis were equall y effective. Propofol-based anaesthesia was more expensive.