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Effect of midazolam, dexamethasone and their combination on the prevention of nausea and vomiting following strabismus repair in children

Published online by Cambridge University Press:  01 August 2007

W. Riad ,
R. Altaf ,
A. Abdulla  and
H. Oudan
W. Riad*
Affiliation:
King Khaled Eye Specialist Hospital, Department of Anaesthesia, Riyadh, Saudi Arabia
R. Altaf
Affiliation:
King Saud University, Faculty of Medicine, Department of Anesthesia, Riyadh, Saudi Arabia
A. Abdulla
Affiliation:
King Saud University, Faculty of Medicine, Department of Anesthesia, Riyadh, Saudi Arabia
H. Oudan
Affiliation:
King Saud University, Faculty of Medicine, Department of Ophthalmology, Riyadh, Saudi Arabia
*
Correspondence to: Waleed Riad, Department of Anaesthesia, King Khaled Eye Specialist Hospital, P.O. Box 7191, Riyadh 11462, Kingdom of Saudi Arabia. E-mail: waleed_riad@yahoo.com; Tel: +966 1 482 1234 3215; Fax: +966 1 482 1908
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Summary

Background

Postoperative nausea and vomiting is a common complication following strabismus surgery. This randomized and double-blind study was designed to evaluate the efficacy of midazolam alone or in combination with dexamethasone in reducing the incidence of postoperative nausea and vomiting in children undergoing strabismus repair.

Methods

One hundred ASA I children, aged 4–12 yr, scheduled to undergo elective strabismus surgery, were enrolled. No premedication was given. Anaesthesia was induced with sevoflurane, nitrous oxide and oxygen. After induction, fentanyl 2 μg kg−1 and cisatracurium 0.1 mg kg−1 were administered and an endotracheal tube was inserted. After induction of anaesthesia and before start of surgery, patients were randomly allocated into one of four groups of 25 children each to receive placebo, midazolam 50 μg kg−1, dexamethasone 0.5 mg kg−1 or a combination of midazolam 50 μg kg−1 and dexamethasone 0.5 mg kg−1. Episodes of nausea, and retching and vomiting were recorded during the first 24 h after surgery.

Results

The incidence of postoperative nausea was 48%, 32%, 12% and 0% with placebo, dexamethasone, midazolam and the midazolam–dexamethasone combination, respectively. The incidence of vomiting was 52% and 32% with placebo and dexamethasone, respectively; no child vomited with midazolam alone, or with the midazolam–dexamethasone combination.

Conclusion

Prophylactic midazolam with or without dexamethasone reduces the incidence of PONV in children undergoing strabismus repair.

Keywords

POSTOPERATIVE NAUSEA AND VOMITINGCHILDRENMIDAZOLAMDEXAMETHASONE
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 8 , August 2007 , pp. 697 - 701
Copyright
Copyright © European Society of Anaesthesiology 2007

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