Splinter W, Roberts D J
Department of Anaesthesia, Children's Hospital of Eastern Ontario and University of Ottawa, Canada.
Anesth Analg. 1997 Sep;85(3):534-7. doi: 10.1097/00000539-199709000-00010.
The effects of dexamethasone and perphenazine on vomiting after tonsillectomy in children were compared in 226 healthy children aged 2-12 yr. The study was randomized, stratified, blocked, and double-blind. Anesthesia was induced intravenously (I.V.) with propofol or by inhalation with halothane and N2O. Dexamethasone 150 microg/kg or perphenazine 70 microg/kg was administered I.V. after the induction of anesthesia in a double-blind fashion. Perioperative management of emesis, pain, fluids, and patient discharge was all standardized. The groups had similar demographic characteristics. Perphenazine significantly reduced the incidence of in-hospital vomiting compared with dexamethasone (13% vs 36%, P < 0.001). The incidence of out-of-hospital vomiting was almost identical. Overall, the incidence was significantly different for perphenazine vs dexamethasone (33% vs 46%, P = 0.04) using logistic regression analysis. Of note, sex and induction technique were significant predictors of postoperative vomiting (P < 0.05) using logistic regression analysis, with male patients and those patients undergoing I.V. induction vomiting less. In conclusion, perphenazine more effectively decreases vomiting by children after tonsillectomy in an ambulatory hospital setting compared with dexamethasone.
Postoperative vomiting can have many debilitating effects, and children undergoing tonsillectomy are at particular risk. We compared the effects of dexamethasone and perphenazine on vomiting after tonsillectomy in 266 children. We found perphenazine more effective than dexamethasone before discharge from hospital but that the two drugs have similar effects after discharge.
在226名2至12岁的健康儿童中比较了地塞米松和奋乃静对儿童扁桃体切除术后呕吐的影响。该研究为随机、分层、区组化和双盲研究。麻醉通过静脉注射丙泊酚或吸入氟烷和一氧化二氮诱导。在麻醉诱导后以双盲方式静脉注射地塞米松150微克/千克或奋乃静70微克/千克。呕吐、疼痛、液体和患者出院的围手术期管理均标准化。两组具有相似的人口统计学特征。与地塞米松相比，奋乃静显著降低了住院期间呕吐的发生率（13%对36%，P<0.001）。院外呕吐的发生率几乎相同。总体而言，使用逻辑回归分析，奋乃静与地塞米松的发生率有显著差异（33%对46%，P=0.04）。值得注意的是，使用逻辑回归分析，性别和诱导技术是术后呕吐的显著预测因素（P<0.05），男性患者和接受静脉诱导的患者呕吐较少。总之，在门诊医院环境中，与地塞米松相比，奋乃静能更有效地减少儿童扁桃体切除术后的呕吐。
术后呕吐会产生许多使人衰弱的影响，接受扁桃体切除术的儿童尤其危险。我们比较了地塞米松和奋乃静对266名儿童扁桃体切除术后呕吐的影响。我们发现，在出院前奋乃静比地塞米松更有效，但两种药物在出院后的效果相似。
