Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-24T11:25:54.543Z Has data issue: false hasContentIssue false
  • English
  • Français

Scheduled prophylactic ondansetron administration did not improve its antiemetic efficacy after intracranial tumour resection surgery in children

Published online by Cambridge University Press:  01 July 2007

K. Subramaniam ,
M. P. Pandia ,
M. Dash ,
H. H. Dash ,
P. K. Bithal ,
A. Bhatia  and
B. Subramaniam
K. Subramaniam*
Affiliation:
University of Pittsburgh Medical Center, Department of Anaesthesiology, Pittsburgh, PA, USA
M. P. Pandia
Affiliation:
All India Institute of Medical Sciences, Neurosciences Center, Department of Anaesthesiology, New Delhi, India
M. Dash
Affiliation:
All India Institute of Medical Sciences, Neurosciences Center, Department of Anaesthesiology, New Delhi, India
H. H. Dash
Affiliation:
All India Institute of Medical Sciences, Neurosciences Center, Department of Anaesthesiology, New Delhi, India
P. K. Bithal
Affiliation:
All India Institute of Medical Sciences, Neurosciences Center, Department of Anaesthesiology, New Delhi, India
A. Bhatia
Affiliation:
All India Institute of Medical Sciences, Neurosciences Center, Department of Anaesthesiology, New Delhi, India
B. Subramaniam
Affiliation:
Harvard Medical School, Beth Israel Deaconess Medical Center, Department of Anaesthesiology, Boston, MA, USA
*
Correspondence to: Kathirvel Subramaniam, Department of Anaesthesiology, UPMC Presbyterian Hospital, C-Wing, 200 Lothrop Street, Pittsburgh, PA 15217, US. E-mail: [email protected]; Tel: +1 4124220575; Fax: +1 412 647 6290
Get access

Summary

Background and objective

Postoperative nausea and vomiting after craniotomy may increase intracranial pressure and morbidity in children. This prospective, randomized, placebo-controlled and double-blinded study was designed to evaluate the antiemetic efficacy of prophylactic ondansetron after intracranial tumour resections in children.

Methods

Ninety children were divided into three groups and received saline (Group 1), ondansetron 150 μg kg−1 intravenously at dural closure (Group 2) or two doses of ondansetron 150 μg kg−1 intravenously, the second dose repeated after 6 h (Group 3). Episodes of nausea, emesis and side-effects were noted for 24 h postoperatively.

Results

Overall 24 h incidence of postoperative nausea and vomiting was not significantly different among the three groups (9 (37.5%) in Group 1 vs. 7 (27%) in Group 2 and 8 (32%) in Group 3, P = 0.73). No difference in rescue antiemetic treatment or postoperative nausea and vomiting at specific time intervals (0–6 and 6–24 h postoperative period) was seen among the three groups. No significant side-effects were noted in any of the three groups.

Conclusions

Ondansetron, in this study of 90 children, was not very effective in preventing nausea and vomiting after neurosurgical operations.

Keywords

ANAESTHESIA, neurosurgicalSURGERY, paediatric craniotomyCOMPLICATION, postoperative nausea and vomitingANTIEMETIC, ondansetron
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 7 , July 2007 , pp. 615 - 619
Copyright
Copyright © European Society of Anaesthesiology 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Manninen, PH, Raman, SK, Boyle, K et al. . Early postoperative complications following neurosurgical procedures. Can J Anaesth 1999; 46: 7–14.CrossRefGoogle ScholarPubMed
2.Fabling, JM, Gan, TJ, Guy, J et al. . Postoperative nausea and vomiting. A retrospective analysis in patients undergoing elective craniotomy. J Neurosurg Anesth 1997; 9: 308–312.CrossRefGoogle ScholarPubMed
3.Fabling, JM, Gan, TJ, El-Moalem, HE et al. . A randomized, double blinded comparison of ondansetron, droperidol and placebo for prevention of postoperative nausea and vomiting after supratentorial craniotomy. Anesth Analg 2000; 91: 358–361.Google ScholarPubMed
4.Pugh, SC, Jones, NC, Barsoum, LZ. A comparison of prophylactic ondansetron and metoclopramide administration in patients undergoing major neurosurgical procedures. Anaesthesia 1996; 51: 1164–1166.CrossRefGoogle ScholarPubMed
5.Kathirvel, S, Dash, HH, Bhatia, A et al. . Effect of prophylactic ondansetron on postoperative nausea and vomiting after elective craniotomy. J Neurosurg Anesthesiol 2001; 13: 207–212.CrossRefGoogle ScholarPubMed
6.Furst, SR, Sullivan, LJ, Soriano, SG et al. . Effects of ondansetron on emesis in the first 24 h after craniotomy in children. Anesth Analg 1996; 83: 325–328.CrossRefGoogle ScholarPubMed
7.Culy, CR, Bhana, N, Plosker, GL. Ondansetron: a review of its use as an antiemetic in children. Paediatr Drugs 2001; 3: 441–479.CrossRefGoogle ScholarPubMed
8.Spahr–Schopfer, IA, Lerman, J, Sikich, N et al. . Pharmacokinetics of intravenous ondansetron in healthy children undergoing ear, nose, and throat surgery. Clin Pharmacol Ther 1995; 58: 316–321.CrossRefGoogle ScholarPubMed
9.Pritchard, JF, Bryson, JC, Kernodle, AE et al. . Age and gender effects on ondansetron pharmacokinetics: evaluation of healthy aged volunteers. Clin Pharmacol Ther 1992; 51: 51–55.CrossRefGoogle ScholarPubMed
10.Henzi, I, Walder, B, Tramer, MR. Dexamethasone for the prevention of postoperative nausea and vomiting: a quantitative systematic review. Anesth Analg 2000; 90: 186–194.CrossRefGoogle ScholarPubMed
11.Irefin, SA, Schubert, A, Bloomfield, EL et al. . The effect of craniotomy location on postoperative pain and nausea. J Anesth 2003; 17: 227–231.CrossRefGoogle ScholarPubMed
12.Kurita, N, Kawaguchi, M, Nakahashi, K et al. . Retrospective analysis of postoperative nausea and vomiting after craniotomy. Masui 2004; 53:150–155.Google ScholarPubMed
13.Gan, TJ, Meyer, T, Apfel, CC et al. . Consensus guidelines for managing postoperative nausea and vomiting. Anesth Analg 2003; 97: 62–71.CrossRefGoogle ScholarPubMed