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Comparison of anti-emetic effects of ondansetron and low-dose droperidol in pediatric strabismus surgery.

BACKGROUND AND OBJECTIVE: Strabismus surgery is associated with a high incidence of postoperative nausea and vomiting. A dose of 150 microg/kg(-1) of ondansetron has been found to be effective in reducing nausea and vomiting in pediatric patients. However, droperidol (20 to 75 microg/kg(-1)) has shown variable success with various side effects. This randomized, double-blind, placebo-controlled clinical trial was conducted to evaluate the efficacy and safety of 25 microg/kg(-1) of droperidol and compare it with that of 150 microg/kg(-1) of ondansetron in pediatric strabismus surgery. PATIENTS AND METHODS: After institutional approval and parental informed consent, 120 children aged 1 to 15 years were prospectively randomized into one of three groups. Group 1 received normal 'saline (placebo), group 2 received 25 microg/kg(-1) of droperidol, and group 3 received 150 microg/kg(-1) of ondansetron after induction of anesthesia. Children were assessed postoperatively for the incidence and severity of vomiting, recovery from anesthesia, and analgesic requirement for 24 hours. RESULTS: There was a significant (P < .05) reduction in the incidence of postoperative nausea and vomiting in the ondansetron (37.5%) and droperidol (30%) groups compared with the placebo (62.5%) group. The vomiting was also significantly less severe in these groups. CONCLUSION: Doses of 25 microg/kg(-1) of droperidol and 150 microg/kg(-1) of ondansetron administered at induction of anesthesia are equally effective in reducing the incidence and severity of postoperative nausea and vomiting in children undergoing strabismus surgery.

Adolescent↗

Influence of type of food on the kinetics and overall production of Bacillus cereus emetic toxin.

Potato puree and penne pasta were inoculated with cereulide producing B. cereus 5964a and B. cereus NS117. Static incubation at 28 degrees C proved these two foods to be a better substrate for higher cereulide production (4,080 ng/g in puree and 3,200 ng/g in penne were produced by B. cereus 5964a during 48 h of incubation) compared with boiled rice (2,000 ng/g). This difference occurred despite B. cereus counts of more than 10(8) CFU/g in all three products. Aeration of cultures had a negative effect on cereulide production, causing concentrations more than 10-fold lower than in some statically incubated samples. Cereulide production remained undetectable in shaken milk, whereas it reached 1,140 ng/ml in statically incubated milk. At 12 and 22 degrees C, presence of background flora was also a determinative factor. A total B. cereus count of more than 106 CFU/ml did not necessarily lead to uniform cereulide production and was also dependent on the B. cereus strain involved. In this study, we confirm that a number of factors play a crucial role in the determination of the extent to which, if at all, cereulide will be produced. Among those, type of the food, temperature, pH, and whether additional aeration (via incubation on an orbital shaker) is induced had an important role. An important effect was also induced by the cereulide-producing strain involved.

Bacillus cereus↗

[Evaluation of the anti-emetic effectiveness of two drug formulations of Ondansetron in combined chemotherapy for children with malignant tumors].

A double-blind randomized comparison (protocol S3AB4003, Glaxo Wellcome, Great Britain) carried out in a group of 52 children showed that the 5-HT3-receptor antagonist ondansetron (in syrup) effectively prevented vomiting, nausea and loss of appetite caused in combination chemotherapy with highly- or moderately emetogenic cytostatic drugs in 92.3; 69.3 and 81.0%, respectively. Treatment was given to patients who were on dexamethasone. With intravenous injection of ondansetron plus dexamethasone, per os, said indices were 88.5; 73.2%; 73.2%, respectively, thus showing no significant differences. No side-effects were observed with either regimen.

Administration, Oral↗

[Anti-emetic treatment for patients with lung cancer after chemotherapy, and usefulness of prochlorperazine for psychiatric emesis].

Clinical study of cisplatin 80 mg/m2 and other agents was undertaken to determine whether they could prevent psychiatric emesis during chemotherapy in 50 patients with lung cancer. YG character tests revealed that 9 patients had a coupled rightward shift in N (nervous) and I (inferior complex) components, and were classified as emotionally unstable. In these 9 cases, addition of 15 mg prochlorperazine to the preventive combined administration of 3 mg granisetoron, 500 mg methylpredonisolon, and 40 mg metoclopramide decreased the post-chemotherapy psychiatric emesis from 100% in 3 control cases to 16.7% in 6 added cases. In the remaining 41 cases, the preventive combined administration alone was effective. The good control of acute emesis is the first priority in emotionally unstable patients. The addition of prochlorperazine might be a useful therapy for psychiatric emesis induced by anticancer agents in emotionally unstable patients.

Aged↗

Anti-emetics.

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Antiemetics↗