INTERNATIONAL JOORNAL OF pediatric ELSEVIER International Journal of Pediatric Otorhinolaryngology 36 (1996) 99-108 Ondansetron decreases postoperative vomiting in pediatric patients undergoing tonsillectomy and adenoidectomy C. David Lawhorn”,*, Charles Bowerb, Raeford E. Brown Jr.“, Michael L. Schmitz”, Patti J. Kymer”, JoAnne Stoner”, J. Michael Vollers”, Robert Shirey” “Department of Anesthesiology, Slot 203, Arkansus Children’s Hospital, 800 Marshull Street. Little Rock, AR 72202, USA bDicision qf Pediatric Otolaryngology, Arkansus Children’s Hospital, 800 Marshall Street, Little Rock. AR 72202, USA ‘Department of’ Pharmacy, Arkansas Children S Hospital, 800 Marshull Street, Little Rock, AR 72202, USA Received 28 August 1995; revised 27 November 1995; accepted 8 December 1995 Abstract One of the most frequently performed pediatric surgical procedures is tonsillectomy and adenoidectomy. Nausea and vomiting and the inability to tolerate oral fluids lead to unplanned hospitalizations. Despite treatment with metoclopramide and droperidol, nausea and vomiting continue to be high after this procedure. We designed this investigation to compare currently utilized antiemetics to ondansetron, a new serotonin antagonist, in hopes of decreasing the occurrence of nausea and vomiting in patients undergoing tonsillectomy and adenoidectomy. This prospective, randomized, double-blinded clinical trial compared ondansetron, droperidol, and placebo administered at the induction of general anesthesia and the incidence of vomiting postoperatively. One-hundred sixty-five children between the ages of 2 and 12 years undergoing ambulatory adenotonsillectomy were enrolled and completed this investigation. The primary outcome measure was the elimination of vomiting during the 24-h investigative period following surgery. Both ondansetron and droperidol significantly lowered the incidence of postoperative emesis after tonsillectomy and adenoidec- tomy (P < 0.012) compared to placebo. Ondansetron was significantly more effective than droperidol in reducing emesis after discharge (P < 0.025). Both ondansetron and droperidol are effective in decreasing emesis when given before surgical incision in pediatric patients undergoing tonsillectomy and adenoidectomy. Ondansetron’s antiemetic effect persists for up * Corresponding author. Tel.: + 1 501 320 2936: fax: + 1 501 320 2939 0165.5876/96/$15.00 0 1996 Elsevier Science Ireland Ltd. All rights reserved SSDI 0165-5876(95)01324-5