Sukhani Radha, Pappas Ana Lucia, Lurie Jordan, Hotaling Andrew J, Park Albert, Fluder Elaine
Department of Anesthesiology, Loyola University Medical Center, Maywood, IL, USA.
Anesth Analg. 2002 Nov;95(5):1230-5, table of contents. doi: 10.1097/00000539-200211000-00021.
In this prospective, randomized, double-blinded, placebo-controlled study, we compared the incidence of emesis and 48-h recovery profiles after a single dose of preoperative ondansetron versus dolasetron in dexamethasone-pretreated children undergoing ambulatory tonsillectomy. One-hundred-forty-nine children, 2-12 yr old, ASA physical status I and II, completed the study. All children received standardized perioperative care, including premedication, surgical and anesthetic techniques, IV fluids, analgesics, and rescue antiemetic medications. Patients were randomized to receive ondansetron 0.15 mg/kg, maximum 4 mg (Group 1); dolasetron 0.5 mg/kg, maximum 25 mg (Group 2); or saline placebo (Group 3) IV before the initiation of surgery. In addition, all patients received dexamethasone 1 mg/kg (maximum 25 mg). Rescue antiemetics were administered for two or more episodes of retching/vomiting. The incidence of retching/vomiting before home discharge did not differ between the ondansetron and dolasetron groups and was significantly less frequent compared with the placebo group (10%, Group 1; 8%, Group 2; 30%, Group 3). Similar results were obtained at 24-48 h after discharge (6%, Groups 1 and 2; 18%, Group 3). The need for rescue antiemetics administered after the second retching/vomiting episode was significantly less in Groups 1 (4%) and 2 (6%) compared with Group 3 (22%) before home discharge. The complete response rate, defined as no retching/vomiting and no antiemetic for 48 h, was significantly increased in Groups 1 (76%) and 2 (74%) compared with Group 3 (44%). The antiemetic efficacy of prophylactic ondansetron and dolasetron was comparable in dexamethasone-pretreated children undergoing ambulatory tonsillectomy.
The efficacy of a single dose of prophylactic ondansetron versus dolasetron in conjunction with dexamethasone was studied on posttonsillectomy retching/vomiting and 48-h recovery in children 2-12 yr old. Compared with placebo, ondansetron and dolasetron produced comparable reductions in the incidence of retching/vomiting and the need for rescue antiemetics.
在这项前瞻性、随机、双盲、安慰剂对照研究中，我们比较了单剂量术前使用昂丹司琼与多潘立酮对接受日间扁桃体切除术且已接受地塞米松预处理的儿童的呕吐发生率及48小时恢复情况。149名2至12岁、美国麻醉医师协会（ASA）身体状况为I级和II级的儿童完成了该研究。所有儿童均接受标准化围手术期护理，包括术前用药、手术及麻醉技术、静脉输液、镇痛药及急救止吐药。患者被随机分为三组，手术开始前静脉注射：第1组为昂丹司琼0.15mg/kg，最大剂量4mg；第2组为多潘立酮0.5mg/kg，最大剂量25mg；第3组为生理盐水安慰剂。此外，所有患者均接受地塞米松1mg/kg（最大剂量25mg）。出现两次或更多次干呕/呕吐发作时给予急救止吐药。出院前，昂丹司琼组和多潘立酮组的干呕/呕吐发生率无差异，且与安慰剂组相比显著更低（第1组为10%；第2组为8%；第3组为30%）。出院后24至48小时也得到了类似结果（第1组和第2组为6%；第3组为18%）。出院前，与第3组（22%）相比，第1组（4%）和第2组（6%）在第二次干呕/呕吐发作后需要使用急救止吐药的情况显著减少。完全缓解率定义为48小时内无干呕/呕吐且未使用止吐药，第1组（76%）和第2组（74%）的完全缓解率显著高于第3组（44%）。在接受日间扁桃体切除术且已接受地塞米松预处理的儿童中，预防性使用昂丹司琼和多潘立酮的止吐效果相当。
研究了单剂量预防性使用昂丹司琼与多潘立酮联合地塞米松对2至12岁儿童扁桃体切除术后干呕/呕吐及48小时恢复情况的影响。与安慰剂相比，昂丹司琼和多潘立酮在降低干呕/呕吐发生率及减少急救止吐药使用需求方面效果相当。
