Volume 18, Issue 9 pp. 878-883

Subhypnotic propofol infusion plus dexamethasone is more effective than dexamethasone alone for the prevention of vomiting in children after tonsillectomy

ALI FUAT ERDEM MD

ALI FUAT ERDEM MD

Departments of Anesthesiology and Reanimation,

Search for more papers by this author
OZGUR YORUK MD

OZGUR YORUK MD

Departments of Anesthesiology and Reanimation,

Search for more papers by this author
HACI AHMET ALICI MD

HACI AHMET ALICI MD

Otorhinolaringology, Medical Faculty, Ataturk University, Erzurum, Turkey

Search for more papers by this author
MEHMET CESUR MD

MEHMET CESUR MD

Otorhinolaringology, Medical Faculty, Ataturk University, Erzurum, Turkey

Search for more papers by this author
CANAN ATALAY MD

CANAN ATALAY MD

Otorhinolaringology, Medical Faculty, Ataturk University, Erzurum, Turkey

Search for more papers by this author
ENVER ALTAS MD

ENVER ALTAS MD

Departments of Anesthesiology and Reanimation,

Search for more papers by this author
HUSNU KURSAD MD

HUSNU KURSAD MD

Otorhinolaringology, Medical Faculty, Ataturk University, Erzurum, Turkey

Search for more papers by this author
MUSTAFA SAHIN YUKSEK MD

MUSTAFA SAHIN YUKSEK MD

Otorhinolaringology, Medical Faculty, Ataturk University, Erzurum, Turkey

Search for more papers by this author
First published: 28 July 2008
Citations: 30
Dr A.F. Erdem, Department of Anesthesiology and Reanimation, Medical Faculty, Ataturk University, Erzurum, Turkey (email: [email protected]).

Summary

Background: Postoperative vomiting (POV) is a common complication after tonsillectomy. Dexamethasone is known to decrease postsurgical vomiting. In this study, we compared the effects of dexamethasone alone to dexamethasone plus propofol on postoperative vomiting in children undergoing tonsillectomy.

Methods: In a randomized double-blinded study, we evaluated 80 healthy children, aged 4–12 years, who underwent tonsillectomy with or without adenoidectomy. After anesthesia was induced by inhalation of sevoflurane, 0.15 mg·kg−1 dexamethasone and 2 μg·kg−1 fentanyl was administered i.v. to all patients. The patients in the dexamethasone plus propofol group received 1 mg·kg−1 propofol before intubation and continuously after intubation at a rate of 20 μg·kg−1·min−1 until the surgery was completed. Data for postoperative vomiting were grouped into the following time periods: 0–4 and 4–24 h. Data were analyzed using a Student’s t-test and chi-squared analysis.

Results: The percentage of patients exhibiting a complete response (defined as no retching or vomiting for 24 h) increased from 37.5% in the dexamethasone-alone group to 75% in the dexamethasone plus propofol group (P = 0.001). Twenty-two patients (55%) in the dexamethasone-alone and nine patients (22.5%) in the dexamethasone plus propofol groups experienced vomited during 0–4 h (P = 0.003). Eight patients in the dexamethasone-alone group and three patients in the dexamethasone plus propofol group received ondansetron as a rescue antiemetic during the postoperative period.

Conclusion: For children undergoing tonsillectomy, intraoperative subhypnotic propofol infusion combined with dexamethasone treatment provides a better prophylaxis against postoperative vomiting than does dexamethasone alone.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.