Ondansetron dose response curve in high-risk pediatric patients

C. David Lawhorn, Patti J. Kymer, Frank C. Stewart, JoAnne Stoner, Robert Shirey, Paula Volpe

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)637-642
Number of pages6
JournalJournal of Clinical Anesthesia
Volume9
Issue number8
DOIs
StatePublished - Dec 1997
Externally publishedYes

Fingerprint

Ondansetron
Pediatrics
Metoclopramide
Adenoidectomy
Vomiting
Postoperative Nausea and Vomiting
Tonsillectomy
Strabismus
Incidence
Placebos
Emetics
Pediatric Hospitals
Premedication
Double-Blind Method
Anesthetics

Keywords

  • Adenoidectomy
  • Anesthesia, pediatric
  • Metoclopramide
  • Ondansetron
  • Strabismus
  • Tonsillectomy

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Ondansetron dose response curve in high-risk pediatric patients. / Lawhorn, C. David; Kymer, Patti J.; Stewart, Frank C.; Stoner, JoAnne; Shirey, Robert; Volpe, Paula.

In: Journal of Clinical Anesthesia, Vol. 9, No. 8, 12.1997, p. 637-642.

Research output: Contribution to journalArticle

Lawhorn, C. David ; Kymer, Patti J. ; Stewart, Frank C. ; Stoner, JoAnne ; Shirey, Robert ; Volpe, Paula. / Ondansetron dose response curve in high-risk pediatric patients. In: Journal of Clinical Anesthesia. 1997 ; Vol. 9, No. 8. pp. 637-642.
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abstract = "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.",
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AU - Lawhorn, C. David

AU - Kymer, Patti J.

AU - Stewart, Frank C.

AU - Stoner, JoAnne

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.

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KW - Adenoidectomy

KW - Anesthesia, pediatric

KW - Metoclopramide

KW - Ondansetron

KW - Strabismus

KW - Tonsillectomy

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