Dolasetron for the prevention of postoperative vomiting in children undergoing strabismus surgery.

BACKGROUND Children undergoing strabismus surgery have a high incidence of postoperative vomiting (POV). The purpose of this study was to assess the efficacy and safety of dolasetron for the prevention of emesis comparing a single 0.35 mg.kg-1 or 12.5 mg dose with placebo. METHODS Children aged 2-12 years with an ASA status of 1 or 2 undergoing strabismus surgery were randomized in a double-blind manner to one of three treatment groups. Patients were excluded with a history of previous postoperative vomiting or motion sickness, allergy to serotonin receptor antagonists or previous antiemetic administration within 24 h prior to enrollment. General anaesthesia was induced with sevoflurane and N2O/O2 and maintained with isoflurane and N2O/O2. The study medication was administered 15 min prior to the end of surgery. Patients experiencing two or more episodes of vomiting were rescued in the postanaesthesia care unit (PACU) with metoclopramide 0.15 mg.kg-1. A total of 118 patients were enrolled with documentation of the number and severity of vomiting episodes, time to awakening, PACU length of stay and postoperative agitation. RESULTS Patients with an acute complete response (ACR), defined as no emetic episodes and no rescue medication within 24 h of study drug administration were 62% (weight dose), 64% (fixed dose) and 33% (placebo, P < 0.05). CONCLUSIONS There was no statistical difference between the 0.35 mg.kg-1 dose and the fixed 12.5 mg dose of dolasetron with both reducing the incidence of POV.