PharmacoEconomics & Outcomes News 381 - 21 Sep 2002

Prophylactic ondansetron worth itin paediatric PONV

Compared with early symptomatic ondansetrontreatment, prophylactic ondansetron can reducepostoperative nausea and vomiting (PONV) and result inlower total direct medication costs among paediatricpatients undergoing strabismus repair surgery, says amultinational group of researchers.

Their prospective, double-blind study involved 150such patients aged 2–15 years who were randomised toreceive prophylaxis (n = 75) or early symptomatictreatment with IV ondansetron 100 µg/kg followingsurgery. Any patient with an episode of PONV receivedIV ondansetron 100 µg/kg as first-line postoperativeantiemetic; if this therapy failed, patients receivedmetoclopramide 150 µg/kg and promethazine 0.5 mg/kgas second- and third-line agents, respectively.

The results showed that, over the first 24 hoursfollowing surgery, patients in the prophylaxis group hada significantly lower incidence of PONV and nauseaalone, compared with those in the early symptomatictreatment group. In addition, there was a significantlylower requirement for rescue antiemetics, and asignificantly shorter stay in the postanaesthesia-careunit, in the prophylaxis, compared with the earlytreatment group. Consequently, the cost to benefit onepatient was considerably lower in the prophylaxis groupcompared with the early treatment group ($US17.80 vs$US76.70), as was the total direct cost of all antiemeticsper PONV-free patient ($US21.30 vs $US28.90.Sennaraj B, et al. Management of post-strabismus nausea and vomiting in childrenusing ondansetron: a value-based comparison of outcomes. British Journal ofAnaesthesia 89: 473-478, Sep 2002 800915686

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PharmacoEconomics & Outcomes News 21 Sep 2002 No. 3811173-5503/10/0381-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved