The effect of ondansetron on the pediatric patients who has agitation cause of sevoflurane

In this study, we aimed to investigate the influence of ondansetron, an antiemetic and 5HT3 antagonist, on sevoflurane-related emergence agitation in pediatric patients. Forty ASA I-II and 1-7 years of age children undergoing elective infraumbilical day-case surgery under general anesthesia with sevoflurane, were included in to the study. The study population was divided into two groups as Group I (n=20) and Group II (n=20). Group I was comprised of children who had undergone surgery previously and required antiemetics due to history of nausea-vomiting during the postoperative period. Group II was the control group. Each patient was subjected to premedication by 0.5 mg/kg oral midazolam 30 minutes prior to the general anesthesia. Thirty minutes after the delivery of the premedication, scores of the patients for parental separation, sedation, and induction of anesthesia were noted. Mask induction of anesthesia was performed with O2 (40%), NO2 (60%) and sevoflurane (7%). Maintenance of anesthesia was achieved with O2 (40%), NO2 (60%) and sevoflurane (endtidal value of 2%). Following induction of anesthesia, both groups received 10 µg/kg intravenous alfentanil, and a laryngeal mask airway matching the weight of each patient, was inserted. All patients were subjected to caudal blockade with 0.8 ml/kg 0.25% bupivacaine. Children in Group I received 0.1 mg/kg intravenous ondansetron following the induction of anesthesia. Group II received no antiemetics. Intraoperatively, the following parameters were monitored: SpO2, electrocardiogram, inspiratory and expiratory O2, NO2 and sevoflurane concentrations, central body temperature (esophageal), and hemodynamics. Duration of exposure to volatile anesthetic and duration of anesthesia as well as length of operation, were noted. CHIPPS pain, PAED scale, and Aldrete scores were evaluated at postoperative 10, 20, 30, 60, 120, and 180 minutes. There was no difference between the study groups with regard to age, body weight, duration of exposure to volatile anesthetic, and length of operation. Times to eye opening, contact with the parents, and utterance of sound were similar in both of the groups (p>0.05). Duration of anesthesia was found to be statistically significantly shorter in the control group than in the ondansetron group (p<0.05). No statistically significant intergroup difference was observed in terms of PAED scores relative to the agitation (p>0.05).In conclusion, perioperative prophylactic use of ondansetron did not reduce the sevoflurane-related emergence agitation in pediatric patients.Key Words: Pediatric, postoperative agitation, sevoflurane, ondansetron.