Comparison of the Prophylactic Effect of Ondansetron, Dexamethasone, and the Combination of These Drugs on Decreasing Nausea and Vomiting in Children Aged 1 to 12 Years Old Undergoing Upper Gastrointestinal Endoscopy

  • Amir Shafa Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
  • Anahita Hirmanpour Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
  • behzad nazemroayasedeh Assistant Professor, Department of Anesthesiology and Critical Care, Isfahan University of Medical Sciences, Isfahan, Iran
  • Fateme Jafari Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
  • Arash Pourreza Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Keywords: Endoscopy, Ondansetron, Dexamethasone, Nausea, Vomiting

Abstract

Background: Endoscopy is a diagnostic and therapeutic method with a high risk of nausea and vomiting. Considering the lack of adequate studies on the prevention of postoperative nausea and vomiting after endoscopy in children, this study was conducted to compare the effects of ondansetron, dexamethasone and a combination of these drugs on the reduction of nausea and vomiting in children aged 1 to 12 years undergoing upper gastrointestinal endoscopy. Methods: In this double-blind, randomized clinical trial, 146 children aged 1 to 12 years, undergoing upper gastrointestinal endoscopy were randomly allocated to four groups of 36. Before endoscopy, the groups received 0.1 mg / kg of ondansetron, 0.2 mg / kg dexamethasone, a combination of the two drugs and placebo, respectively. Results: According to the results of our study, children who underwent upper GI endoscopy, administration of ondansetron plus dexamethasone was associated with a significantly lower frequency of nausea in all assessment time points. However, the difference between the groups was significant only on admission to recovery and the 15 minutes after admission to recovery (P<0.001). Conclusion: The results of our study indicated that in children undergoing endoscopy, the use of ondansetron plus dexamethasone is associated with reduction in the incidence of nausea and vomiting, and the use of the combination does not cause significant side effects compared to ondansetron, dexamethasone or placebo, separately.

References

Louise R, Martin S, Pernilla S, Mette H , Gastroscopy in Pediatric Surgery. Indications, Complications, Outcomes, and Ethical Aspects, Gastroenterology Research and Practice; Volume 2015 (2015), Article ID 820340, 8

Wang B, He KH, Jiang MB, Liu C, Min S. Effect of prophylactic dexamethasone on nausea and vomiting after laparoscopic gynecological operation: meta-analysis. Middle East J Anaesthesiol. 2011 Oct; 21(3):397-402.

Nakagawachi A1, Yoshino J, Miura D, Izumi K, Jimi N, Sumiyoshi R,et al. Prophylactic effect of diphenhydramine on postoperative vomiting in children after laparoscopic surgery. Masui. 2012 Sep; 61(9):988-92.

Fujii Y. Current management of vomiting after tonsillectomy in children. Curr Drug Saf. 2009 Jan; 4(1):62-73.

Riad W, Marouf H. Combination therapy in the prevention of PONV after strabismus surgery in children: granisetron, ondansetron, midazolam with dexamethasone. Middle East J Anaesthesiol. 2009 Oct; 20(3):431-6.M,

Höhne C. Postoperative nausea and vomiting in pediatric anesthesia. Curr Opin Anaesthesiol. 2014 Jun; 27(3):303-8.

Kovac AL. Management of postoperative nausea and vomiting in children. Paediatr Drugs. 2007; 9(1):47-69.

Shen YD, Chen CY, Wu CH, Cherng YG, Tam KW. Dexamethasone, ondansetron, and their combination and postoperative nausea and vomiting in children undergoing strabismus surgery: a meta-analysis of randomized controlled trials. Paediatr Anaesth. 2014 May; 24(5):490-8.

De Orange FA, Marques J, Flores M, Borges PS. Dexamethasone versus ondansetron in combination with dexamethasone for the prophylaxis of postoperative vomiting in pediatric outpatients: a double blind, randomized, placebo-controlled clinical trial. Paediatr Anaesth. 2012 Sep; 22(9):890-6.

Sayyed Morteza Heidari, Hamid Saryazdi, Amir Shafa, Reza Arefpour. Comparison of the effect of preoperative administration of Ringer’s solution, normal saline and hypertonic saline 5% on postoperative nausea and vomiting: A randomized double-blinded clinical study. Pak J Med.2011july; 27(4); 771-774.

Sayyed Morteza Heidari, Mojtaba Rahimi, Fater Saeb, Amir Shafa. Comparison of the effect of intravenous midazolam, metoclopramide and their combination on the treatment of postoperative nausea and vomiting: A double blinded clinical study. Pakistan Journal of Medical Sciences. 2011july; 27(4); 551-556.

Ismail EA, Bakri MH, Abd-Elshafy SK. Dexamethasone alone versus in combination with intra-operative super-hydration for postoperative nausea and vomiting prophylaxis in female patients undergoing laparoscopic cholecystectomy: a randomized clinical trial. Korean J Anesthesiol. 2017 Oct;70(5):535-541.

Fournier N, Cherpillod J, Waridel F, Nydegger M, Albrecht E. A randomised controlled trial of placebo, droperidol or ondansetron to prevent nausea and vomiting after tonsillectomy in children receiving dexamethasone. Anaesthesia. 2017 Jul; 72(7):859-863.

Bamgbade OA, Oluwole O, Khaw RR. Perioperative Antiemetic Therapy for Fast Track Laparoscopic Bariatric Surgery. Obes Surg. 2017 Nov 7.

Published
2018-12-29
How to Cite
1.
Shafa A, Hirmanpour A, nazemroayasedeh behzad, Jafari F, Pourreza A. Comparison of the Prophylactic Effect of Ondansetron, Dexamethasone, and the Combination of These Drugs on Decreasing Nausea and Vomiting in Children Aged 1 to 12 Years Old Undergoing Upper Gastrointestinal Endoscopy. AACC. 5(1):10-4.
Section
Research Article(s)