Regional analgesia combined with avoidance of narcotics may reduce the incidence of postoperative vomiting in children

Samia N. Khalil, Adel Farag, Ehab Hanna, Ranganathan Govindaraj, Alice Z. Chuang

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)123-132
Number of pages10
JournalMiddle East Journal of Anesthesiology
Volume18
Issue number1
StatePublished - Feb 2005
Externally publishedYes

Fingerprint

Postoperative Nausea and Vomiting
Narcotics
Analgesia
Incidence
Anesthesia
Outpatients
Parental Consent
Pediatrics
Antiemetics
Herniorrhaphy
Midazolam
Bupivacaine
Nitrous Oxide
Halothane
Postoperative Pain
Masks
General Anesthesia
Fasting
Prospective Studies
Oxygen

Keywords

  • Avoidance of narcotics
  • Children
  • Outpatients
  • Postoperative vomiting
  • Presurgical caudal blocks

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Regional analgesia combined with avoidance of narcotics may reduce the incidence of postoperative vomiting in children. / Khalil, Samia N.; Farag, Adel; Hanna, Ehab; Govindaraj, Ranganathan; Chuang, Alice Z.

In: Middle East Journal of Anesthesiology, Vol. 18, No. 1, 02.2005, p. 123-132.

Research output: Contribution to journalArticle

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