The effect of methods of ondansetron administration on nausea and vomiting during intravenous patient-controlled analgesia in pediatric patients undergoing pectus excavatum repair

Shin, Youn Sik; Kim, Jae Hwan; Baek, Sung Moon; Lee, Yoon Sook; Kim, Woon Young; Chang, Moon Seok; Park, Young Cheol

Clinical Research

Anesthetic Pharmacology

Anesthesia and Pain Medicine 2008;3(4):250-254.
Published online October 30, 2008.

The effect of methods of ondansetron administration on nausea and vomiting during intravenous patient-controlled analgesia in pediatric patients undergoing pectus excavatum repair

Youn Sik Shin, Jae Hwan Kim, Sung Moon Baek, Yoon Sook Lee, Woon Young Kim, Moon Seok Chang, Young Cheol Park

Department of Anesthesiology and Pain Medicine, Korea University College of Medicine, Seoul, Korea. anejhkim@korea.ac.kr

Abstract

BACKGROUND
Postoperative nausea and vomiting remain troublesome problems, especially in pediatric patients receiving the opioid analgesics. This study was designed to evaluate the difference between bolus injection and continuous infusion of ondansetron for the prevention of postoperative nausea and vomiting in pediatric patients with intravenous patient-controlled analgesia (IV-PCA). METHODS: Sixty patients undergoing pectus excavatum repair were randomly assigned into three groups, no antiemetic (Group 1, n = 20), intraoperative ondansetron 0.1 mg/kg IV bolus (Group 2, n = 20), ondansetron 0.1 mg/kg mixed with IV-PCA (Group 3, n = 20). The incidence of nausea, vomiting, the need for rescue antiemetics, side effects and pain score were recorded for 48 hr postoperatively. RESULTS: The incidence of nausea in Group 2 (20%) and Group 3 (25%) was significantly lower than Group 1 (60%). There was no significant difference in the incidence of vomiting among the groups (Group 1:60%, Group 2:20%, Group 3:20%). The need for rescue antiemetics was significantly lower in Group 2 and 3 than Group 1. CONCLUSIONS: In pediatric patients undergoing pectus excavatum repair, bolus injection and continuous infusion of ondansetron were effective in preventing postoperative nausea during IV-PCA. And the need for rescue antiemetics was significantly decreased.

Key Words: intravenous patient-controlled analgesia, nausea and vomiting, ondansetron, pectus excavatum