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Canadian Journal of Anesthesia, Vol 38, 54-60, Copyright © 1991 by Canadian Anesthesiologists' Society

ARTICLES

Antiemetic prophylaxis with promethazine or droperidol in paediatric outpatient strabismus surgery

VF Blanc, P Ruest, J Milot, JL Jacob and A Tang
Department of Anaesthesia, Hopital Sainte-Justine, Montreal, Quebec, Canada.

This randomized, double-blind study evaluated the antiemetic efficacy and the side-effects of promethazine pretreatment (0.5 mg.kg-1 IV + 0.5 mg.kg-1 IM) versus droperidol + placebo pretreatment (droperidol, 0.075 mg.kg-1 IV + physiological saline, 0.02 ml.kg-1 IM). One hundred unpremedicated ASA physical status I children ranging from two to ten years, and undergoing outpatient strabismus surgery were studied. All children received inhalational anaesthesia with halothane, nitrous oxide and oxygen. Neither opioids nor muscle relaxants were used. The incidence of vomiting and/or retching and the incidence of side-effects were determined in the post-anaesthesia recovery room (PARR), in the short-stay surgical unit (SSSU), and after discharge from the hospital (including the journey and the stay at home during the first postoperative day). Promethazine and droperidol were equally effective in reducing the incidence of vomiting before discharge to two and eight per cent respectively. On the contrary, the incidence of vomiting after discharge and overall were significantly less with promethazine (ten and ten per cent) than with droperidol pretreatment (54 and 56 per cent) (P less than 0.0001). Promethazine permitted the time to discharge from the hospital to be reduced to an average of three hours, without increasing the incidence of vomiting postdischarge. Promethazine pretreatment is much less expensive than droperidol pretreatment. The incidence of restlessness was significantly less with droperidol (eight per cent) than with promethazine (36 per cent) (P less than 0.001). Promethazine pretreatment demands the use of an analgesic like acetaminophen in order to reduce the incidence of postoperative pain and restlessness.(ABSTRACT TRUNCATED AT 250 WORDS)


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K. T. Kwon, S. E. Rudkin, and M. l. Langdorf
Antiemetic Use in Pediatric Gastroenteritis: A National Survey of Emergency Physicians, Pediatricians, and Pediatric Emergency Physicians
Clinical Pediatrics, November 1, 2002; 41(9): 641 - 652.
[Abstract] [PDF]


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Copyright © 1991 by the Canadian Anesthesiologists' Society.