Investigation of the effect of intravenous ondancetron on Qtc interval on electrocardiogram after application of intravenous ondancetron in child patients presenting with acute gastroenteritis infection

Introduction and Purpose: Nausea and vomiting symptoms seen in children with acute gastroenteritis infection (AGE) constitute a significant portion of admissions to the pediatric emergency department. Control of nausea and vomiting in children is very important in the treatment of acute gastroenteritis. In order to prevent vomiting, it is generally preferred to give antiemetic treatment intravenously due to the decrease in oral intake. Ondansetron is one of the leading antiemetics. It is an antagonist of 5-hydroxytryptamine type 3 but may cause QT prolongation due to its mechanism of action.The pediatric dosage is 0,15mg/kg/dose. In our study, we aimed to investigate whether there would be a prolongation in the Qtc value. This was measured by performing an ECG before and 1 hour after the administration of 0.15 mg/kg/dose intravenous onasetron in children between the ages of 6 months and 18 years with a diagnosis of acute gastroenteritis who presented to the pediatric emergency department with complaints of nausea and vomiting. Material and Method: Our study was designed as a prospective study. In our study, 85 patients aged between 6 months and 18 years who presented with acute gastroenteritis, which had no oral intake, and had mild to moderate dehydration (1-8%) and were administered intravenous onasetron were included. A 12-lead ECG was taken for each patient before and 60 minutes after intravenous ondansetron administration. In this study, it was aimed to determine the duration of QTC prolongation and the incidence of arrhythmia in pediatric patients given ondansetron. In addition, the change parameters of QTC prolongation according to age, gender, degree of dehydration, administered dose of onasetron, and body weight were recorded. Results: In our study, a significant difference was seen in the Qtc value calculated by both the Bazzet and Frederica methods in the ECG taken before and 1 hour after the drug. This value remained as a significant 20 ms and a potentially worrying Qtc prolongation of 30 ms. No definite QTC prolongation exceeding 60 ms was observed. A Qtc value exceeding 0.44 ms was not calculated in any patient. It was observed that there was no significant difference in QTC prolongation according to the parameters of age, gender, degree of dehydration, administered dose of onasetron, and body weight. Conclusion: No significant prolongation was observed in the Qtc values calculated. We think that Ondansetron can be used safely in pediatric patients.