Document Detail


Regional analgesia combined with avoidance of narcotics may reduce the incidence of postoperative vomiting in children.
MedLine Citation:
PMID:  15830767     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The anesthesia literature cites a high incidence of postoperative vomiting (POV) after pediatric ochidopexy and hernia repair (34-50%) and after penile procedures (37-49%). We hypothesized that regional analgesia combined with avoidance of narcotics administered to children scheduled for lower abdominal or urologic procedures may be associated with a lower incidence of POV. The aim of this prospective study was to 1) assess the incidence of POV in children in the hospital and during a 24-h post-anesthesia study period, and 2) evaluate the effect of age on POV. METHODS: After obtaining institutional and parental consent, 110 pediatric outpatients, 1-12 yr old, ASA physical status I or II, scheduled for elective outpatient urologic or lower abdominal procedures, were enrolled. Children were fasting and premedicated with midazolam, 0.5 mg/kg p.o. They received a combined light general anesthesia and a presurgical caudal block. Anesthesia was induced via a mask and consisted of halothane and nitrous oxide in oxygen. For the caudal block 1 ml/kg of 0.25% bupivacaine or 0.2% ropivacaine were used to provide intra- and postoperative pain relief. No prophylactic antiemetics were administered. RESULTS: All caudal blocks provided adequate intraoperative pain relief. The incidence of POV was low, 12% at the hospital, 13% for the 24-h study period, and was not affected by age. CONCLUSIONS: We concluded that regional analgesia combined with the avoidance of narcotics administered to children scheduled for elective urologic or lower abdominal procedures, is associated with a lower incidence of POV and that age did not affect the incidence of POV.
Authors:
Samia N Khalil; Adel Farag; Ehab Hanna; Ranganathan Govindaraj; Alice Z Chuang
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Middle East journal of anesthesiology     Volume:  18     ISSN:  0544-0440     ISO Abbreviation:  Middle East J Anesthesiol     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-04-15     Completed Date:  2005-05-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8604187     Medline TA:  Middle East J Anesthesiol     Country:  Lebanon    
Other Details:
Languages:  eng     Pagination:  123-32     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, The University of Texas Medical School at Houston, Texas, USA. Samia.N.Khalil@uth.tmc.edu
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Child
Child, Preschool
Humans
Incidence
Infant
Midazolam / therapeutic use
Narcotics / adverse effects*
Nerve Block
Pain, Postoperative / drug therapy*
Postoperative Nausea and Vomiting / epidemiology,  prevention & control*
Preanesthetic Medication
Prospective Studies
Chemical
Reg. No./Substance:
0/Narcotics; 59467-70-8/Midazolam

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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