TY - JOUR
T1 - Ondansetron dose response curve in high-risk pediatric patients
AU - Lawhorn, C. David
AU - Kymer, Patti J.
AU - Stewart, Frank C.
AU - Stoner, Jo Anne M.
AU - Shirey, Robert
AU - Volpe, Paula
PY - 1997/12
Y1 - 1997/12
N2 - Study Objective: To establish a dose-response relationship for ondansetron, and to evaluate any effects of oral premedication with metoclopramide in pediatric patients undergoing tonsillectomy and adenoidectomy and strabismus surgery. Design: Prospective, randomized, double blind study. Setting: University affiliated, 280-bed pediatric hospital. Patients: 320 ASA physical status I and II patients between the ages of 2 and 12 years undergoing tonsillectomy and adenoidectomy or strabismus surgery. Interventions: Patients were randomized to eight investigational groups. Patients in all eight groups underwent a standard anesthetic. Groups 1, 2, 3, and 4 received intravenous (IV) saline or IV ondansetron at doses of 0.05 mg/kg, 0.1 mg/kg and 0.15 mg/kg, respectively. Groups 5, 6, 7, and 8 received oral metoclopramide 0.15 mg/kg as well as IV saline, and ondansetron 0.05 mg/kg, 0.1 mg/kg, or 0.15 mg/kg. Patients were evaluated for emetic episodes prior to and following discharge. Measurements and Main Results: All doses of ondansetron 0.05 mg/kg; 0.1 mg/kg; and 0.15 mg/kg were significantly more effective than placebo in reducing the incidence of emesis prior to, following discharge, and during the first 24 postoperative hours (p < 0.001). There were no significant differences in the occurrence of emesis between the groups receiving ondansetron 0.05 mg/kg, 0.1 mg/kg, and 0.15 mg/kg. The addition of oral metoclopramide 0.15 mg/kg had no effect on the incidence of emesis in the ondansetron or placebo study groups. Conclusions: Ondansetron is an effective medication for the treatment and prevention of postoperative nausea and vomiting, and a dose of ondansetron 0.05 mg/kg is as effective as 0.1 mg/kg and 0.15 mg/kg. Metoclopramide 0.15 mg/kg has no effect on the incidence of postoperative nausea and vomiting.
AB - Study Objective: To establish a dose-response relationship for ondansetron, and to evaluate any effects of oral premedication with metoclopramide in pediatric patients undergoing tonsillectomy and adenoidectomy and strabismus surgery. Design: Prospective, randomized, double blind study. Setting: University affiliated, 280-bed pediatric hospital. Patients: 320 ASA physical status I and II patients between the ages of 2 and 12 years undergoing tonsillectomy and adenoidectomy or strabismus surgery. Interventions: Patients were randomized to eight investigational groups. Patients in all eight groups underwent a standard anesthetic. Groups 1, 2, 3, and 4 received intravenous (IV) saline or IV ondansetron at doses of 0.05 mg/kg, 0.1 mg/kg and 0.15 mg/kg, respectively. Groups 5, 6, 7, and 8 received oral metoclopramide 0.15 mg/kg as well as IV saline, and ondansetron 0.05 mg/kg, 0.1 mg/kg, or 0.15 mg/kg. Patients were evaluated for emetic episodes prior to and following discharge. Measurements and Main Results: All doses of ondansetron 0.05 mg/kg; 0.1 mg/kg; and 0.15 mg/kg were significantly more effective than placebo in reducing the incidence of emesis prior to, following discharge, and during the first 24 postoperative hours (p < 0.001). There were no significant differences in the occurrence of emesis between the groups receiving ondansetron 0.05 mg/kg, 0.1 mg/kg, and 0.15 mg/kg. The addition of oral metoclopramide 0.15 mg/kg had no effect on the incidence of emesis in the ondansetron or placebo study groups. Conclusions: Ondansetron is an effective medication for the treatment and prevention of postoperative nausea and vomiting, and a dose of ondansetron 0.05 mg/kg is as effective as 0.1 mg/kg and 0.15 mg/kg. Metoclopramide 0.15 mg/kg has no effect on the incidence of postoperative nausea and vomiting.
KW - Adenoidectomy
KW - Anesthesia, pediatric
KW - Metoclopramide
KW - Ondansetron
KW - Strabismus
KW - Tonsillectomy
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U2 - 10.1016/S0952-8180(97)00194-3
DO - 10.1016/S0952-8180(97)00194-3
M3 - Article
C2 - 9438891
AN - SCOPUS:0031464577
SN - 0952-8180
VL - 9
SP - 637
EP - 642
JO - Journal of Clinical Anesthesia
JF - Journal of Clinical Anesthesia
IS - 8
ER -