Effect of dexmedetomidine on prevention of postoperative nausea and vomiting in pediatric strabismus surgery: A randomized controlled study

Abstract Background Postoperative nausea and vomiting (PONV) are common side-effects following strabismus surgery. The present study aimed to compare the effects of different doses of dexmedetomidine (DEX) on PONV incidence in pediatric patients undergoing strabismus surgery. Methods In this prospective randomized double-blinded study, 126 pediatric patients undergoing strabismus surgery were randomized into one of three groups: Placebo group, normal saline; DEX1 group, 0.3 ug/kg dexmedetomidine, and DEX2 group, 0.5 ug/kg dexmedetomidine. Oculocardiac reflex (OCR) events were recorded during surgery. PONV or postoperative vomiting (POV) was recorded for 24 hours in the ward. Pediatric anesthesia emergence delirium (PAED) scale and emergence agitation (EA) scale were recorded in the recovery room. Results Intraoperative OCR was significantly reduced in DEX2 group (41.5%) as compared to that of Placebo group (68.3%) (p=0.026). During the first 24 hours post-op, the overall incidence of PONV was significantly lower in DEX2 group (9.8%) than that of Placebo group (31.7%) (p=0.029). There was no significant difference in POV among the three groups. PAED or EA scores among the three groups were similar during recovery time. Conclusion Dexmedetomidine (0.5 ug/kg) reduced OCX and PONV without lengthening extubation time or recovery time in pediatric patients undergoing strabismus surgery.

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Effect of dexmedetomidine on prevention of postoperative nausea and vomiting in pediatric strabismus surgery: A randomized controlled study

10.21203/rs.2.9506/v4 ◽

2020 ◽

Author(s):

shuangshuang li ◽

Tingjie Liu ◽

Junming Xia ◽

Jie Jia ◽

Wenxian Li

Keyword(s):

Placebo Group ◽

Postoperative Nausea ◽

Recovery Time ◽

Pediatric Patients ◽

Postoperative Nausea And Vomiting ◽

Strabismus Surgery ◽

Nausea And Vomiting ◽

Controlled Study ◽

Extubation Time ◽

Significant Difference

Abstract Background : Postoperative nausea and vomiting (PONV) are common side-effects following strabismus surgery. The present study aimed to compare the effects of different doses of dexmedetomidine (DEX) on PONV incidence in pediatric patients undergoing strabismus surgery. Methods : In this prospective randomized double-blinded study, 126 pediatric patients undergoing strabismus surgery were randomized into one of three groups: Placebo group, normal saline; DEX1 group, 0.3 ug/kg dexmedetomidine, and DEX2 group, 0.5 ug/kg dexmedetomidine. Oculocardiac reflex (OCR) events were recorded during surgery. PONV or postoperative vomiting (POV) was recorded for 24 hours in the ward. Pediatric anesthesia emergence delirium (PAED) scale and emergence agitation (EA) scale were recorded in the recovery room. Results : Intraoperative OCR was significantly reduced in DEX2 group (42%) as compared to that of Placebo group (68%) (p=0.0146). During the first 24 hours post-op, the overall incidence of PONV was significantly lower in DEX2 group (10%) than that of Placebo group (32%) (p=0.0142). There was no significant difference in POV among the three groups. PAED or EA scores among the three groups were similar during recovery time. Conclusion : Dexmedetomidine (0.5 ug/kg) reduced OCR and PONV without lengthening extubation time or recovery time in pediatric patients undergoing strabismus surgery.

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Effect of dexmedetomidine on prevention of postoperative nausea and vomiting in pediatric strabismus surgery: A randomized controlled study

10.21203/rs.2.9506/v2 ◽

2019 ◽

Author(s):

shuangshuang li ◽

Tingjie Liu ◽

Junming Xia ◽

Jie Jia ◽

Wenxian Li

Keyword(s):

Placebo Group ◽

Postoperative Nausea ◽

Recovery Time ◽

Pediatric Patients ◽

Postoperative Nausea And Vomiting ◽

Strabismus Surgery ◽

Nausea And Vomiting ◽

Controlled Study ◽

Extubation Time ◽

Significant Difference

Abstract Background : Postoperative nausea and vomiting (PONV) are common side-effects following strabismus surgery. The present study aimed to compare the effects of different doses of dexmedetomidine (DEX) on PONV incidence in pediatric patients undergoing strabismus surgery. Methods : In this prospective randomized double-blinded study, 126 pediatric patients undergoing strabismus surgery were randomized into one of three groups: Placebo group, normal saline; DEX1 group, 0.3 ug/kg dexmedetomidine, and DEX2 group, 0.5 ug/kg dexmedetomidine. Oculocardiac reflex (OCR) events were recorded during surgery. PONV or postoperative vomiting (POV) was recorded for 24 hours in the ward. Pediatric anesthesia emergence delirium (PAED) scale and emergence agitation (EA) scale were recorded in the recovery room. Results : Intraoperative OCR was significantly reduced in DEX2 group (42%) as compared to that of Placebo group (68%) (p=0.0146). During the first 24 hours post-op, the overall incidence of PONV was significantly lower in DEX2 group (10%) than that of Placebo group (32%) (p=0.0142). There was no significant difference in POV among the three groups. PAED or EA scores among the three groups were similar during recovery time. Conclusion : Dexmedetomidine (0.5 ug/kg) reduced OCR and PONV without lengthening extubation time or recovery time in pediatric patients undergoing strabismus surgery.

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Effect of dexmedetomidine on prevention of postoperative nausea and vomiting in pediatric strabismus surgery: A randomized controlled study

10.21203/rs.2.9506/v5 ◽

2020 ◽

Author(s):

shuangshuang li ◽

Tingjie Liu ◽

Junming Xia ◽

Jie Jia ◽

Wenxian Li

Keyword(s):

Clinical Trial ◽

Placebo Group ◽

Postoperative Nausea ◽

Recovery Time ◽

Pediatric Patients ◽

Postoperative Nausea And Vomiting ◽

Strabismus Surgery ◽

Nausea And Vomiting ◽

Emergence Agitation ◽

Oculocardiac Reflex

Abstract Background: Postoperative nausea and vomiting (PONV) are common side-effects following strabismus surgery. The present study aimed to compare the effects of different doses of dexmedetomidine (DEX) on PONV incidence in pediatric patients undergoing strabismus surgery. Methods: In this prospective randomized double-blinded study, 126 pediatric patients undergoing strabismus surgery were randomized into one of three groups: Placebo group, normal saline; DEX1 group, 0.3 ug/kg dexmedetomidine, and DEX2 group, 0.5 ug/kg dexmedetomidine. Oculocardiac reflex (OCR) events were recorded during surgery. PONV or postoperative vomiting (POV) was recorded for 24 hours in the ward. Pediatric anesthesia emergence delirium (PAED) scale and emergence agitation (EA) scale were recorded in the recovery room. Results: Intraoperative OCR was significantly reduced in DEX2 group (42%) as compared to that of Placebo group (68%) (p=0.0146). During the first 24 hours post-op, the overall incidence of PONV was significantly lower in DEX2 group (10%) than that of Placebo group (32%) (p=0.0142). There was no significant difference in POV among the three groups. PAED or EA scores among the three groups were similar during recovery time. Conclusion: Dexmedetomidine (0.5 ug/kg) reduced OCR and PONV without lengthening extubation time or recovery time in pediatric patients undergoing strabismus surgery. Trial registration：The trial was prospectively registered before patient enrollment at Chinese Clinical Trial Registry (Clinical Trial Number: ChiCTR1800020176, Date: 12/19/2018). Keywords: Dexmedetomidine, Postoperative nausea and vomiting, Strabismus surgery, Oculocardiac reflex, Emergence agitation

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Inspired Oxygen Fraction of 0.8 Does Not Attenuate Postoperative Nausea and Vomiting after Strabismus Surgery

Anesthesiology ◽

10.1097/00000542-200507000-00005 ◽

2005 ◽

Vol 103 (1) ◽

pp. 6-10 ◽

Cited By ~ 31

Author(s):

Tanja A. Treschan ◽

Christian Zimmer ◽

Christoph Nass ◽

Bernd Stegen ◽

Joachim Esser ◽

...

Keyword(s):

General Anesthesia ◽

Intravenous Administration ◽

Postoperative Nausea ◽

Postoperative Nausea And Vomiting ◽

Strabismus Surgery ◽

Nausea And Vomiting ◽

Controlled Study ◽

Oxygen Fraction ◽

Significant Difference ◽

Inspired Oxygen

Background Postoperative nausea and vomiting (PONV) is a distressing problem after strabismus surgery. An inspired oxygen fraction has been reported to decrease PONV in patients after colon resection and to be more effective than ondansetron after gynecologic laparoscopy. Therefore, in a randomized, prospective, placebo-controlled study, the authors tested whether an inspired oxygen fraction of 0.8 decreases PONV in patients undergoing strabismus surgery and whether oxygen is more effective than ondansetron. Methods With approval of the authors' institutional review board, 210 patients were randomly assigned to receive one of three treatments: (1) 30% inspired oxygen in air plus intravenous administration of saline, (2) 80% inspired oxygen in air plus intravenous administration of saline, or (3) 30% inspired oxygen in air plus 75 microg/kg ondansetron intravenously during induction. General anesthesia was standardized and included etomidate, alfentanil, and mivacurium for induction and sevoflurane for maintenance. PONV was evaluated 6 and 24 h postoperatively by an investigator unaware of treatment assignment. Results Overall postoperative incidence of nausea and vomiting was 41% for inspired oxygen fraction of 0.3 plus placebo, 38% for inspired oxygen fraction of 0.8 plus placebo, and 28% for inspired oxygen fraction of 0.3 plus ondansetron, respectively (P = 0.279). Therefore, there was no statistically significant difference of PONV incidence among groups. Conclusions An inspired oxygen fraction of 0.8 during general anesthesia with sevoflurane does not decrease PONV in patients undergoing strabismus repair. Ondansetron also did not significantly decrease PONV in our study setting.

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Granisetron versus Granisetron-Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Pediatric Strabismus Surgery: A Randomized Double-Blind Trial

Anesthesiology Research and Practice ◽

10.1155/2016/4281719 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Renu Sinha ◽

Dilip Shende ◽

Souvik Maitra ◽

Neeraj Kumar ◽

Bikash Ranjan Ray ◽

...

Keyword(s):

Postoperative Nausea ◽

Postoperative Nausea And Vomiting ◽

Complete Response ◽

Strabismus Surgery ◽

Nausea And Vomiting ◽

Fisher Exact Test ◽

Double Blind ◽

Exact Test ◽

Oculocardiac Reflex ◽

Significant Difference

Aim.Efficacy of granisetron and combination of granisetron and dexamethasone was evaluated for prevention of postoperative nausea and vomiting (PONV) in children undergoing elective strabismus surgery.Methods.A total of 136 children (1–15 years) were included. Children received either granisetron (40 mcg/kg) [group G] or combination of granisetron (40 mcg/kg) and dexamethasone (150 mcg/kg) [group GD]. Intraoperative fentanyl requirement and incidence and severity of oculocardiac reflex were assessed. PONV severity was assessed for first 24 hours and if score was >2, it was treated with metoclopramide. Postoperative analgesia was administered with intravenous fentanyl and ibuprofen.Results.The demographic profile, muscles operated, and fentanyl requirement were comparable. Complete response to PONV in first 24 hours was observed in 75% (51/68) of children in group G and 76.9% (50/65) of children in group GD, which was comparable statistically (p=0.96, Fisher exact test; OR 1.11, 95% CI 0.50, 2.46). Incidence of PONV between 0 and 24 hours was comparable. One child in group G required rescue antiemetic in first 24 hours and none of the children had severe PONV in group GD. There was no significant difference in incidence or severity of oculocardiac reflex.Conclusion.Dexamethasone did not increase efficacy of granisetron for prevention of PONV in elective pediatric strabismus surgery. Registration number of clinical trial wasCTRI/2009/091/001000.

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Effect of dexmedetomidine on prevention of postoperative nausea and vomiting in pediatric strabismus surgery: a randomized controlled study

BMC Ophthalmology ◽

10.1186/s12886-020-01359-3 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Shuangshuang Li ◽

Tingjie Liu ◽

Junming Xia ◽

Jie Jia ◽

Wenxian Li

Keyword(s):

Postoperative Nausea ◽

Postoperative Nausea And Vomiting ◽

Strabismus Surgery ◽

Nausea And Vomiting ◽

Randomized Controlled Study ◽

Controlled Study ◽

Randomized Controlled

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Using diazepam and atropine before strabismus surgery to prevent postoperative nausea and vomiting: a randomized, controlled study

Journal of American Association for Pediatric Ophthalmology and Strabismus ◽

10.1016/j.jaapos.2003.10.002 ◽

2004 ◽

Vol 8 (2) ◽

pp. 211

Author(s):

Robert W Arnold

Keyword(s):

Postoperative Nausea ◽

Postoperative Nausea And Vomiting ◽

Strabismus Surgery ◽

Nausea And Vomiting ◽

Randomized Controlled Study ◽

Controlled Study ◽

Randomized Controlled

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Prophylactic Ondansetron in Prevention of Postoperative Nausea and Vomiting following Pediatric Strabismus Surgery

Anesthesiology ◽

10.1097/00000542-200004000-00021 ◽

2000 ◽

Vol 92 (4) ◽

pp. 1035-1042 ◽

Cited By ~ 57

Author(s):

Senthilkumar Sadhasivam ◽

Dilip Shende ◽

Rashmi Madan

Keyword(s):

Placebo Group ◽

Outcome Measures ◽

Postoperative Nausea ◽

Postoperative Nausea And Vomiting ◽

Strabismus Surgery ◽

Nausea And Vomiting ◽

Postanesthesia Care Unit ◽

Assessment Scores ◽

Parental Assessment ◽

Prophylactic Use

Background This study evaluated the antiemetic effectiveness, dose-response, and clinical usefulness of prophylactic ondansetron in the prevention of postoperative nausea and vomiting (PONV) in children undergoing strabismus repair. Method The authors observed 180 children, American Society of Anesthesiologists physical status I or II, 2-12 yr of age, who were undergoing strabismus repair. After induction of anesthesia with halothane and nitrous oxide in oxygen or intravenous thiopental, children received either placebo (saline) or intravenous ondansetron in doses of 25, 50, 75, 100, and 150 /microg/kg (n = 30). The trachea was intubated and ventilation was controlled. Perioperative analgesic and fluid requirements were standardized. Episodes of nausea and vomiting were recorded for the first 24 h postoperatively. Data such as nonsurrogate (parental satisfaction scores and duration of postanesthesia care unit stay) and therapeutic (numbers needed to prevent and harm) outcome measures were collected. Results The incidences of PONV in the placebo and 25-, 50-, 75-, 100-, and 150-,microg/kg ondansetron groups were 83, 77, 47, 30, 30, and 27%, respectively. The incidence was less in the 75(P = 0.002), 100- (P = 0.002), and 150-microg/kg (P < 0.001) ondansetron groups compared with placebo. Duration of stay in the postanesthesia care unit was shorter in the 75-, 100-, and 150-microg/kg ondansetron groups (P < 0.002) compared with the placebo group. Parental assessment scores for the child's perioperative experience and the positive number needed to prevent PONV were also better and favorable in the 75-, 100-, and 150-microg/kg ondansetron groups compared with the placebo group. The incidence (P > 0.99) and severity (P = 0.63) of PONV were similar in the 75- and 150-microg/kg ondansetron groups. Surrogate, nonsurrogate, and therapeutic outcome measures revealed that 75 microg/kg ondansetron provided the same benefits as did 100 and 150 microg/kg. Conclusion The routine prophylactic use of ondansetron at a dose of 75 microg/kg is as effective as 150 microg/kg in preventing PONV and improving the "true" outcome measures after strabismus repair in children.

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Is Infusion of Subhypnotic Propofol as Effective as Dexamethasone in Prevention of Postoperative Nausea and Vomiting Related to Laparoscopic Cholecystectomy? A Randomized Controlled Trial

BioMed Research International ◽

10.1155/2015/349806 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 10

Author(s):

Mine Celik ◽

Aysenur Dostbil ◽

Mehmet Aksoy ◽

Ilker Ince ◽

Ali Ahiskalioglu ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Postoperative Nausea ◽

Controlled Trial ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Controlled Study ◽

Control Group ◽

Double Blind ◽

Significant Difference ◽

Group D

Background. Postoperative nausea and vomiting (PONV) is one of common complications in patients undergoing laparoscopic cholecystectomy (LC). Aim of this study was to compare the efficacy of subhypnotic (1 mg/kg/h) infusion of propofol with dexamethasone on PONV in patients undergoing LC.Methods. A total of 120 patients were included in this randomized, double-blind, placebo-controlled study. Patients were randomly assigned to 3 groups; patients of group dexamethasone (group D) were administrated 8 mg dexamethasone before induction of anesthesia, patients of group propofol (group P) were infused to subhypnotic (1 mg/kg/h) propofol during operation and patients of group control (group C) were applied infusion of 10% intralipid. The incidence of PONV and needs for rescue analgesic and antiemetic were recorded in the first 24 h postoperatively.Results. In the 0–24 h, the incidence of PONV was significantly lower in the group D and group P compared with the group C (37.5%, 40%, and 72.5%, resp.). There was no significant difference in the incidence of PONV and use of antiemetics and analgesic between group D and group P.Conclusion. We concluded that infusion of propofol 1 mg/kg/h is as effective as dexamethasone for the prevention of PONV during the first 24 hours after anesthesia in patients undergoing LC.

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