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 Scopus citations

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 1 2005
Externally publishedYes

Keywords

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

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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