Effect of intravenous fluid therapy on postoperative vomiting in children undergoing tonsillectomy.

Abstract

BACKGROUND:

Postoperative vomiting (POV) is one of the most frequent complications of tonsillectomy in children. The aim of this study was to evaluate the antiemetic effect of super-hydration with lactated Ringer's solution in children undergoing elective otorhinolaryngological surgery.

METHODS:

One hundred ASA I-II children, aged 1-12 yr, undergoing elective tonsillectomy, with or without adenoidectomy, under general anaesthesia were studied. Induction and maintenance of anaesthesia were standardized with fentanyl, mivacurium, and sevoflurane in N(2)O/O(2). Subjects were assigned to one of the two groups: 10 ml kg(-1) h(-1) lactated Ringer's solution or 30 ml kg(-1) h(-1) lactated Ringer's solution. A multivariable logistic regression was used for assessing the effects of super-hydration on POV (defined as the presence of retching, vomiting, or both). A value of P<0.05 was considered statistically significant.

RESULTS:

During the first 24 h postoperative, the incidence of POV decreased from 82% to 62% (relative reduction of 24%, P=0.026). In the adjusted logistic regression model, subjects in the 10 ml kg(-1) h(-1) group had an odds ratio of POV that was 2.92 (95% confidence interval: 1.14, 7.51) for POV compared with subjects in the 30 ml kg(-1) h(-1) group.

CONCLUSIONS:

Intraoperative administration of 30 ml kg(-1) h(-1) lactated Ringer's solution significantly reduced the incidence of POV during the first 24 h postoperative. Our results support the use of super-hydration during tonsillectomy, as an alternative way to decrease the risk of POV in children.

• Authors: M F Elgueta, G C Echevarría, N De la Fuente, F Cabrera, A Valderrama, R Cabezón, H R Muñoz, L I Cortinez
• Journal: British journal of anaesthesia (Br J Anaesth) Vol. 110 Issue 4 Pg. 607-14 (Apr 2013) ISSN: 1471-6771 [Electronic] England
• PMID: 23257991 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antiemetics

Topics

• Anesthesia Recovery Period
• Anesthesia, General
• Antiemetics (therapeutic use)
• Child
• Child, Preschool
• Cost-Benefit Analysis
• Female
• Fluid Therapy (economics, methods)
• Humans
• Infant
• Logistic Models
• Male
• Postoperative Nausea and Vomiting (economics, epidemiology, therapy)
• Tonsillectomy (adverse effects, economics)
• Treatment Outcome