Original contribution
A randomized, double-blind, placebo controlled comparison of droperidol, ondansetron, and metoclopramide for the prevention of vomiting following outpatient strabismus surgery in children

https://doi.org/10.1016/S0952-8180(97)00143-8Get rights and content

Abstract

Study Objective: To compare the efficacy of ondansetron, droperidol, or metoclopramide with placebo in preventing postoperative vomiting following strabismus surgery.

Study Design: Randomized, double-blind, placebo-controlled clinical trial.

Setting: University outpatient surgery center.

Patients: 160 ASA physical status I and II children ages 1 to 12 years who were scheduled for strabismus surgery.

Interventions: Administration of either ondansetron 100 mcg/kg, metoclopramide 250 mcg/kg, droperidol 75 mcg/kg, or placebo intravenously after induction of anesthesia.

Measurements and Main Results: Both ondansetron and droperidol were superior to metoclopramide and placebo in preventing predischarge vomiting, with incidences of 5%, 5%, 32%, and 25%, respectively. However, there was no difference in the incidence of postdischarge vomiting among the groups (ondansetron 25 %, droperidol 25 %, metoclopramide 20%, and placebo 25%).

Conclusions: While both ondansetron and droperidol are more effective than metoclopramide when compared with placebo in decreasing the incidence of predischarge vomiting, none of these drugs was more effective than placebo in decreasing the incidence of postdischarge vomiting. Recovery from anesthesia was not significantly different among the groups as assessed by time to awakening, initial Steward score, and time to discharge.

References (37)

  • JF Hardy et al.

    Nausea and vomiting after strabismus surgery in preschool children

    Can Anaesth Soc J

    (1986)
  • S Christensen et al.

    Incidence of emesis and postanesthetic recovery after strabismus surgery in children: a comparison of droperidol and lidocaine

    Anesthesiology

    (1989)
  • LJ Dupre et al.

    Extrapyramidal syndromes after premedication with droperidol in children

    Br J Anaesth

    (1980)
  • JD Grimes et al.

    Adverse neurologic effects of metoclopramide

    Can Med Assoc J

    (1982)
  • DE Casey

    Metoclopramide side effects [Letter]

    Ann Intern Med

    (1983)
  • PE Scuderi et al.

    Treatment of postoperative nausea and vomiting after outpatient surgery with the 5-HT3 antagonist ondansetron

    Anesthesiology

    (1993)
  • R McKenzie et al.

    Comparison of ondansetron versus placebo to prevent postoperative nausea and vomiting in women undergoing ambulatory gynecologic surgery

    Anesthesiology

    (1993)
  • A Davis et al.

    A double-blind randomized prospective study comparing ondansetron with droperidol in the prevention of emesis following strabismus surgery

    Anaesth Intensive Care

    (1995)
  • Cited by (34)

    • Ophthalmology

      2019, A Practice of Anesthesia for Infants and Children
    • Ophthalmology

      2018, A Practice of Anesthesia for Infants and Children
    • Ophthalmology

      2009, A Practice of Anesthesia for Infants and Children
    • Ophthalmology

      2008, A Practice of Anesthesia for Infants and Children: Expert Consult
    • Prophylaxis of postoperative vomiting in children undergoing tonsillectomy: A systematic review and meta-analysis

      2006, British Journal of Anaesthesia
      Citation Excerpt :

      The evidence for dolasetron, although weaker, also suggests that it is a suitable agent for the prophylactic control of POV in this patient group. The results of the pooled anti-serotinergic analysis are consistent with the literature in other patient groups which indicate that this group of drugs are highly effective anti-emetic agents.47637274105 Meta-analysis of the studies investigating the effect of metoclopramide suggests that it is also an effective agent.

    View all citing articles on Scopus

    Presented in part at the Annual Meeting of the American Society of Anesthesiologists, San Francisco, October 15–19, 1994.

    Associate Professor of Anesthesia.

    Assistant Professor of Ophthalmology.

    Biostatistician, Department of Anesthesia

    §

    Assistant Professor of Anesthesia.

    Professor of Anesthesia.

    View full text