A randomised study presented here on June 20 at the 2015 Annual Meeting of the Canadian Anesthesiologists’ Society (CAS) suggests that dextrose can be used in paediatric patients to decrease postoperative vomiting (POV).
POV is common in children and often may lead to hospital admissions, said Kelly Anne Fedoruk, MD, Department of Anesthesiology, University of Saskatchewan, Saskatoon, Saskatchewan.
“This study was looking to see if dextrose would be an effective tool to reduce our incidence [of POV],” she said, noting that children aged 3 to 9 years have a very high risk of experiencing POV. “It (dextrose) is not expensive, and it has a very good side effect profile.”
Another benefit of dextrose is that it is temperature-stable, making it easy to be transported, noted Dr. Fedoruk.
The investigators designed the study to look at the non-inferiority of dextrose to ondansetron.
The non-inferiority study saw double-blind randomisation of 290 children aged 3 to 9 years who were classified as having a low risk of POV and who were undergoing ambulatory dental surgery. The control arm (n = 145) was administered intravenous dexamethasone 0.15 mg/kg and ondansetron 0.05mg/kg and the active treatment group (n = 144) was administered dexamethasone 0.15 mg/kg plus 5% dextrose in 0.9% normal saline maintenance fluid.
The researchers found no significant difference in emesis between the 2 arms in the post anaesthetic care unit (P = .11), suggesting dextrose was not less effective than ondansetron. Of note, investigators found children who vomited in the post anaesthetic care unit were 6.2 times more likely to vomit at 24 hours (P = .015).
A future study will likely compare the use of dexamethasone and ondansetron to the combination of dexamethasone, ondansetron, and dextrose, said Dr. Fedoruk. “We are looking at possibly using all 3 together to further reduce the incidence of vomiting,” said she said.