Effect of antiemetic therapy on recovery and hospital discharge time. A double-blind assessment of ondansetron, droperidol, and placebo in pediatric patients undergoing ambulatory surgery.

Abstract:

BACKGROUND:Postoperative nausea and vomiting continue to be a significant problem for pediatric ambulatory surgery patients. Although ondansetron has been demonstrated to be effective in the prophylactic treatment of postoperative nausea and vomiting (surrogate end point) no one has demonstrated a benefit of antiemetic therapy on patient recovery, postanesthesia care unit length of stay, and hospital length of stay (nonsurrogate end points). In a double-blind manner, the effects of ondansetron, droperidol, and placebo on the incidence of emesis, postanesthesia care unit stay, and hospital discharge time were evaluated in children undergoing dental surgery. METHODS:The subjects were 102 children aged 2-8 years undergoing complete dental restoration. All patients received midazolam before undergoing inhalation induction of anesthesia with N2O/O2 and halothane. Anesthesia was maintained with N2O/O2 and alfentanil. Patients were then randomized to receive ondansetron (0.1 mg/kg), droperidol (75 micrograms/kg), or placebo (normal saline) in a double-blind fashion. At the conclusion of the anesthesia, a trained nurse observer assessed patient recovery and recorded the time patients met specified criteria for postanesthesia care unit and hospital discharge as well as episodes of emesis in the hospital and at home during the first 24 hr after surgery. RESULTS:Ninety-five patients completed the study. The three antiemetic groups were similar with respect to age, weight, length of surgery, dose of alfentanil, and route of preanesthetic medication. The 24-hr incidence of emesis was significantly less with ondansetron (9%) than with placebo (35%) or droperidol (32%). Ondansetron-treated patients had significantly shorter hospital stays than droperidol-treated patients, but recovery parameters were similar between the ondansetron- and placebo-treated patients. CONCLUSIONS:Ondansetron is an effective prophylactic antiemetic agent for children undergoing dental surgery. Compared with droperidol, ondansetron decreases the length of hospital stay, but compared to placebo, there were no differences in the patient recovery parameters.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Davis PJ,McGowan FX Jr,Landsman I,Maloney K,Hoffmann P

doi

10.1097/00000542-199511000-00007

subject

Has Abstract

pub_date

1995-11-01 00:00:00

pages

956-60

issue

5

eissn

0003-3022

issn

1528-1175

journal_volume

83

pub_type

临床试验,杂志文章,随机对照试验
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  • Lack of nephrotoxicity by 6% hydroxyethyl starch 130/0.4 during hip arthroplasty: a randomized controlled trial.

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    更新日期:1990-05-01 00:00:00

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    doi:

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  • A brief regional ischemic-reperfusion enhances propofol-induced depression in left ventricular function of in situ rat hearts.

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    更新日期:1994-05-01 00:00:00

  • Factors affecting perioperative transfusion decisions in patients with coronary artery disease undergoing coronary artery bypass surgery.

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  • Influence of administration rate on propofol plasma-effect site equilibration.

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    pub_type: 杂志文章,随机对照试验

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    pub_type: 临床试验,杂志文章,随机对照试验

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    doi:10.1097/00000542-199101000-00009

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    更新日期:1991-01-01 00:00:00

  • Ethanol and contraction of venous smooth muscle.

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    doi:10.1097/00000542-197604000-00009

    authors: Edgarian H,Altura BM

    更新日期:1976-04-01 00:00:00

  • Gestational differences in lidocaine toxicity in the fetal lamb.

    abstract::Effects of lidocaine on arterial pressure, heart rate and electrocortical activity were studied in nine fetal lambs at 0.77 to 0.92 gestation (116 to 138 days of gestation; term in sheep is 150 days). Lidocaine was administered into a fetal femoral vein either as a continuous infusion or as a bolus injection. Epilepti...

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    authors: Teramo K,Benowitz N,Heymann MA,Rudolph AM

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  • Isoflurane causes endothelium-dependent inhibition of contractile responses of canine coronary arteries.

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    authors: Blaise G,Sill JC,Nugent M,Van Dyke RA,Vanhoutte PM

    更新日期:1987-10-01 00:00:00

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  • Diabetes-associated alterations in volatile anesthetic actions on contractile response to norepinephrine in isolated mesenteric resistance arteries.

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    更新日期:2010-03-01 00:00:00

  • Buprenorphine metabolites, buprenorphine-3-glucuronide and norbuprenorphine-3-glucuronide, are biologically active.

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    pub_type: 杂志文章

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    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000748

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    更新日期:2015-09-01 00:00:00

  • Cognitive Functioning after Surgery in Middle-aged and Elderly Danish Twins.

    abstract:BACKGROUND:Postoperative cognitive dysfunction is common, but it remains unclear whether there are long-term adverse cognitive effects of surgery combined with anesthesia. The authors examined the association between exposure to surgery and level of cognitive functioning in a sample of 8,503 middle-aged and elderly twi...

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    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000957

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    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

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    更新日期:1998-10-01 00:00:00

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    pub_type: 杂志文章

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  • Evaluation of low-dose endotoxin administration during pregnancy as a model of preeclampsia.

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    pub_type: 临床试验,杂志文章

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    pub_type: 杂志文章

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