Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038379 (strabismus)
 9,317 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Vomiting after strabismus surgery is a major problem that remains as yet unsolved, especially in children. Droperidol and metoclopramide, both known as powerful antiemetic drugs, were compared in this study. METHODS. One hundred ASA class I and II children ranging from 3 to 10 years of age were studied in a double-blind, randomised fashion. They were assigned to three groups: group D (n = 33) received 0.075 mg/kg droperidol, group M (n = 33) 0.15 mg/kg metoclopramide, and group N (n = 34) 0.1 ml/kg NaCl i.v. upon arrival in the post-anaesthesia recovery room (PARR). After oral premedication with 0.4 mg/kg midazolam, anaesthesia was induced via a face mask by inhalation of halothane, nitrous oxide, and oxygen. Barbiturates, atropine, and succinylcholine were not used; 0.05 mg/kg vecuronium was given to facilitate intubation. Gastric contents were aspirated by a gastric tube at the end of the operation. Vomiting and retching were recorded for 24 h; recovery from anaesthesia was assessed by a modified Steward score. RESULTS. The three groups were comparable regarding age, body weight, duration of anaesthesia, number of repaired eye muscles, and occurrence of the oculocardiac reflex (OCR). During the first 24 h postoperatively 21/33 (64%) patients of group D vomited, 24/33 (73%) of group M, and 33/34 (97%) of group N. The differences between groups D and N and between M and N were significant (P less than 0.01); comparison of groups D and M showed no statistical significance. Droperidol was more effective in reducing severe vomiting. Of the group N children, 47% vomited more than 6 times in 24 h compared to 18% of group M and 0% of group D. Age, sex, duration of anaesthesia, number of repaired eye muscles, and occurrence of the OCR had no influence on postoperative vomiting. Despite being administered at the end of the operation, droperidol did not prolong the patients' stay in the PARR. The post-anaesthetic scores for group D children were only slightly lower compared to groups M and N. CONCLUSIONS. Droperidol (0.075 mg/kg) and metoclopramide (0.15 mg/kg) both reduce postoperative vomiting after strabismus surgery. Droperidol seems to be more effective in reducing severe vomiting. Postoperative sedation after droperidol was not a major problem in our experience.
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PMID:[Droperidol versus metoclopramide. Prevention of emesis following strabismus surgery in children]. 161 15

This randomized, double-blind study evaluated the antiemetic efficacy and the side-effects of promethazine pretreatment (0.5 mg.kg-1 IV + 0.5 mg.kg-1 IM) versus droperidol + placebo pretreatment (droperidol, 0.075 mg.kg-1 IV + physiological saline, 0.02 ml.kg-1 IM). One hundred unpremedicated ASA physical status I children ranging from two to ten years, and undergoing outpatient strabismus surgery were studied. All children received inhalational anaesthesia with halothane, nitrous oxide and oxygen. Neither opioids nor muscle relaxants were used. The incidence of vomiting and/or retching and the incidence of side-effects were determined in the post-anaesthesia recovery room (PARR), in the short-stay surgical unit (SSSU), and after discharge from the hospital (including the journey and the stay at home during the first postoperative day). Promethazine and droperidol were equally effective in reducing the incidence of vomiting before discharge to two and eight per cent respectively. On the contrary, the incidence of vomiting after discharge and overall were significantly less with promethazine (ten and ten per cent) than with droperidol pretreatment (54 and 56 per cent) (P less than 0.0001). Promethazine permitted the time to discharge from the hospital to be reduced to an average of three hours, without increasing the incidence of vomiting postdischarge. Promethazine pretreatment is much less expensive than droperidol pretreatment. The incidence of restlessness was significantly less with droperidol (eight per cent) than with promethazine (36 per cent) (P less than 0.001). Promethazine pretreatment demands the use of an analgesic like acetaminophen in order to reduce the incidence of postoperative pain and restlessness.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Antiemetic prophylaxis with promethazine or droperidol in paediatric outpatient strabismus surgery. 198 40

Children recovering from anaesthesia for strabismus surgery are particularly prone to nausea and vomiting as a result of intraoperative vagus irritation. Besides being disturbing to the patient, vomiting can be dangerous during emergence from anesthesia and can result in delayed discharge. Droperidol is a powerful antiemetic drug that has been shown to reduce the incidence and severity of postoperative nausea and vomiting in pediatric strabismus patients, although the best timing for administration is not clear. MATERIAL AND METHODS. We compared three randomized groups totalling 61 patients. Droperidol 0.075 mg/kg i.v. was given either at induction of anesthesia after intubation (n = 20) or during the last muscle suture (n = 21). The third group received no antiemetic treatment. The patients' ages ranged from 3 to 14 years (mean 5.9 +/- 2.84 years). There was no difference in age or sex between the three groups. Anesthesia was standardized with rectal midazolam premedication, atropine, thiopental, succinylcholine, O2/N2O = 1:2, enflurane, intubation, and a gastric tube. RESULTS. Nausea, retching, or vomiting occurred in 2/20 children (10%) given droperidol preoperatively, 4/21 children (19%) with droperidol during the operation, and 9/20 children (45%) with no antiemetic treatment. The difference between groups I and III was significant (p less than 0.05). Comparison of groups II and III and groups I and II showed no statistical significance. Operation time was similar in each group and there was no delay in time of extubation. In each group 1 case of hypotension occurred. No child showed extrapyramidal symptoms. The lower incidence of vomiting in all study groups compared to the literature is thought to be due to three factors: (1) emptying the stomach at the end of the operation by a gastric tube, which is removed before extubation; (2) avoidance of opioids; (3) surgical procedure being done by a very experienced surgeon in 57/61 children (12 vomiting versus 45 not vomiting) in contrast to 3/4 children vomiting postoperatively after surgery by a less experienced surgeon. CONCLUSIONS. We recommend preoperative droperidol 75 micrograms/kg i.v. as the best prophylaxis of postoperative emesis without severe side effects in pediatric strabismus surgery.
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PMID:[The prevention of postoperative vomiting following strabismus surgery in children]. 204 9

In children, strabismus surgery is frequently followed by vomiting. The present study compares the antiemetic effects of droperidol (10 micrograms/kg) and/or metoclopramide (0.1 mg/kg) in 104 children undergoing strabismus surgery. The patients were randomly divided into four groups. Group I (n = 28) received placebo (saline), Group II (n = 26) droperidol 10 micrograms/kg, Group III (n = 25) metoclopramide 0.1 mg/kg and Group IV (n = 25) droperidol 10 micrograms/kg and metoclopramide 0.1 mg/kg. Droperidol was given just after induction and metoclopramide at the end of surgery, just before recovery. The technique of anesthesia involved an anticholinergic premedication, IV fentanyl (2 micrograms/kg), controlled ventilation using isoflurance and N2O in oxygen and systematic gastric emptying before extubation. Vomiting, retching and nausea were noted at 5 different moments: in the Post Anesthetic Care Unit, when arriving on the ward (= after carriage by lift), during the first hour following the return in the ward, from the 6th to the 12th postoperative hour and on the morning of day 1. There was no statistically significant difference in the incidence of vomiting among these four groups. Moreover, the incidence of vomiting in the placebo group was much lower (17.9% in the recovery room, 3.6% at return in the ward, 25% during the first hour, 7.1% from 6 to 12 hours and 3.6% the next day) than that reported in previous studies. We think that this could result from the additive effects of some aspects of the technique of anesthesia described and discussed in this paper.
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PMID:Open placebo controlled comparison of the antiemetic effect of droperidol, metoclopramide or a combination of both in pediatric strabismus surgery. 834 2

Although droperidol is often used to prevent emesis, vomiting is still common in children undergoing strabismus surgery. METHODS. One hundred children aged 3 to 12 years admitted for strabismus surgery were enrolled in a randomised, double-blind study to investigate the influence of the timing of the administration of droperidol (75 micrograms/kg i.v.) and the effect of atropine (10 micrograms/kg i.v.) on postoperative vomiting and the occurrence of the oculocardiac reflex (OCR). Each child was prospectively assigned to one of the following groups: Group A: atropine and droperidol before the beginning of surgery (n = 25); Group B: atropine before the beginning, droperidol after completion of surgery (n = 25); Group C: no atropine, droperidol before the beginning of surgery (n = 25); Group D: no atropine, droperidol after completion of surgery (n = 25). After oral premedication with 0.4 mg/kg midazolam, anaesthesia was induced via a face mask by inhalation of halothane, nitrous oxide, and oxygen and 1 mg/kg succinylcholine was given to facilitate tracheal intubation. Gastric contents were aspirated by a gastric tube at the end of the operation. Vomiting and retching were recorded for 24 h; recovery from anaesthesia was assessed by a modified Steward score. RESULTS. The four groups were comparable regarding age, sex, body weight, duration of anaesthesia, and number of repaired eye muscles. Patients receiving droperidol before and after the end of surgery had a similar incidence of vomiting (groups A and C 60% vs. groups B and D 50%). There was no significant difference in the number of patients vomiting between groups A and B (58%) and groups C and D (52%). The incidence of the OCR was lower in the patients premedicated with atropine (18% vs. 60%, P < 0.01). There was no statistical relationship between the occurrence of the OCR and post-operative emesis. Younger children (3 to 6 years) vomited more often than older ones (7 to 12 years). The incidence of the OCR was higher in patients with more than two eye muscles repaired than in others. Recovery scores were slightly lower in patients with droperidol after completion of surgery; postoperative recovery times did not differ significantly between the study groups. CONCLUSIONS. The timing of the administration of droperidol (75 micrograms/kg) had no influence on postoperative vomiting. The application of atropine (10 micrograms/kg) prior to surgery did not influence vomiting after strabismus surgery. Atropine (10 micrograms/kg) reduced the incidence of the OCR significantly. There was no statistical relationship between the occurrence of the OCR and postoperative vomiting.
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PMID:[Emesis and the oculocardiac reflex. Drug prophylaxis with droperidol and atropine in children undergoing strabismus surgery]. 834 44

This study was undertaken to compare the efficacy of granisetron plus droperidol with each antiemetic alone for the prevention of vomiting after paediatric strabismus surgery. In a prospective, randomized, double-blinded trial, 120 ASA physical status I children, aged 4-10 years, received granisetron 40 microg.kg- 1, droperidol 50 microg.kg- 1, granisetron 40 microg.kg- 1 plus droperidol 50 microg.kg- 1 (n=40 of each) intravenously after an inhalation induction of anaesthesia. A complete response, defined as no vomiting, no retching and no need for another rescue antiemetic medication, during 0-3 h after anaesthesia was 80% with granisetron, 45% with droperidol and 98% with granisetron plus droperidol, respectively; the corresponding incidence during 3-24 h after anaesthesia was 78%, 38% and 98% (P< 0.05; overall chi-squared test with Yates continuity correction). No clinically important adverse events were observed in any of the groups. In conclusion, a combination of granisetron and droperidol was more effective than granisetron or droperidol as a sole antiemetic for the prevention of postoperative vomiting in children undergoing strabismus repair.
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PMID:Combination of granisetron and droperidol for the prevention of vomiting after paediatric strabismus surgery. 2729 Jul 48