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Effect of Dexmedetomidine, Dexamethasone, and Ondansetron on Postoperative Nausea and Vomiting in Children Undergoing Dental Rehabilitation: A Randomized Controlled Trial

A. Shama, Amir Abouzkry Elsayed, Abdulrahman A Albraithen, Sherif K. Arafa

Pain Physician, 2023

7 citations

Abstract

BACKGROUND

Postoperative nausea and vomiting (PONV) are common unpleasant adverse effects after surgery. The incidence of PONV in pediatric patients is often twice as high as in adults.

OBJECTIVES

This study aimed to evaluate the effects of dexmedetomidine, dexamethasone, and ondansetron for preventing PONV in children undergoing dental rehabilitation surgery.

STUDY DESIGN

A prospective, randomized controlled clinical trial.

SETTING

Sharurah Armed Forces Hospital, Ministry of Defense Medical Services, Saudi Arabia.

METHODS

One hundred patients (6-12 years old) scheduled for dental rehabilitation were included. Patients were randomly allocated into 4 groups (25 each) to receive either 0.15 mg/kg dexamethasone (DEX), 0.05 mg/kg ondansetron (OND), 0.3 microgram/kg dexmedetomidine (DEXMED), or normal saline (control[CONT]) in DEX, OND, DEXMED or CONT groups, respectively, via infusion after induction of anesthesia. The primary outcome was a PONV incident in the first 24 hours. Secondary outcomes were: granisetron doses during 24 hours postoperative, Paediatric Anaesthesia Emergence Delirium (PAED) scale, Pediatric Objective Pain Scale (POPS) for 4 hours postoperatively, and complications in the first 24 hours.

RESULTS

The reduction of PONV and the overall number of patients who developed PONV was statistically significant in the DEXMED group compared to the CONT group (P = 0.041). However, the DEXMED group was higher compared to the DEX and OND groups but not statistically…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.

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