Rescue Emetic Therapy for Children Having Elective Surgery



Status:Withdrawn
Conditions:Hospital
Therapuetic Areas:Other
Healthy:No
Age Range:3 - 18
Updated:11/19/2017
Start Date:February 2010
End Date:February 2014

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Rescue Emetic Therapy for Children Having Elective Therapy

To compare ondansetron, metoclopramide, diphenhydramine, and placebo in order to determine
which anti-emetic is most efficacious as a "rescue therapy" for pediatric patients ages 3-18
who have post-operative vomiting after a standardized prophylactic regimen of ondansetron and
dexamethasone. We hypothesize that anti-emetics with a different mechanism of action than the
prophylactic regimen will be the most effective "rescue therapy" in children having surgery
in an ambulatory surgery center.

1. Problem: Despite commonly-used anti-emetics for prophylaxis, some children still go on
to develop post-operative vomiting (POV).

Goal: To determine which anti-emetic--ondansetron, metoclopramide, diphenhydramine, or
placebo--is most efficacious for pediatric patients in this situation.

2. Hypothesis: Anti-emetic medications that have a different mechanism of action than the
prophylactic regimen will be the most efficacious "rescue therapy."

3. Hypothesis: Metoclopramide at the dose of 0.5 mg/kg (max dose 20 mg) will be more
effective than ondansetron, diphenhydramine, or placebo as "rescue therapy."


Inclusion Criteria:

1. Pediatric patients 3-17 years old

2. Patients scheduled for tonsillectomy and/or adenoidectomy (with and without
myringotomy) , or dental restoration,

3. Patients receiving a general anesthetic (inhaled agent without nitrous oxide) with POV
prophylaxis with two agents (ondansetron and dexamethasone)

4. Post operative vomiting in PACU or second stage recovery requiring antiemetic rescue.

Exclusion Criteria:

1. Vomiting in the past 24 hours or antiemetics in previous 24 hours

2. Allergy or sensitivity to ondansetron, dexamethasone, metoclopramide, or
diphenhydramine

3. Patients with diabetes

4. Patients with seizures

5. Patients receiving a benzodiazepine premedication
We found this trial at
1
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3414 Fifth Avenue
Pittsburgh, Pennsylvania 15213
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