Abstract
Purpose
To test the hypothesis that perphenazine decreases the incidence of vomiting by children after tonsillectomy.
Methods
Healthy children (n = 260) aged 2–12 yr undergoing elective tonsillectomy on a day care surgical basis were studied in this randomised, stratified, blocked, double-blind investigation. General Anaesthesia was induced intravenously with propofol or by inhalation with halothane and N2O. Perphenazine 70 μg·kg−1 up to 5 mg or placebo iv was administered before surgery. Management of perioperative fluids, emesis and pain were all standardised.
Results
The groups were similar with respect to demographic data. There was less vomiting after perphenazine during the first 24 hr after surgery 42% (95% CI = 34%–50%) vs 57% (95% CI = 48%–66%, placebo), P < 0.01. On the day of surgery, both in and out-of hospital emesis were decreased by perphenazine. The perphenazine treated patients required fewer rescue antiemetics than the control group, P < 0.05. Each episode of in-hospital vomiting delayed discharge by 20 ± 7 min (mean ± SD). P = 0.007.
Conclusion
The prophylactic administration of perphenazine decreases vomiting by children after tonsillectomy.
Résumé
Objectif
Vérifier si la perphénazine diminue l’incidence des vomissements après une amygdalectomie chez l’enfant.
Méthodes
Des enfants bien portants (n = 260) âgés de deux à 12 ans soumis à une amygdalectomie en chirurgie réglée dans un centre de jour ont participé à cette investigation randomisée, stratifiée, avec blocs et en double aveugle. L’anesthésie générale était induite par la voie veineuse de propofol ou par inhalation d’halothane et de N2O. Avant la chirurgie, on administrait iv de la perphénazine 70 μg·kg−1 jusqu’à 5 mg ou un placebo. La prise en charge des liquides périopératoires, des vomissements et de la douleur était uniformisée.
Résultats
Les groupes étaient comparables sous l’aspect démographique. Les vomissements survenaient moins souvent après la perphénazine pendant les premieres 24 h postchirurgicales, 42% (IC 95% = 34%–50%) vs 57% (IC 95% = 48%–66%), P < 0,01. Le jour de la chirurgie, les épisodes émétiques intraet extrahospitaliers diminuaient sous perphénazine. Les patients traités à la perphénazine ont eu besoin de moins d’antiémétiques de sauvetage que le groupe contrôle, P < 0,05. Chaque épisode de vomissements intrahospitaliers a retardé le congé de 10 ± 7 min (moyenne ± ÉT), P = 0,007.
Conclusion
L’administration prophylactique de perphénazine diminue les vomissements après l’amygdalectomie chez l’enfant.
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This work was presented in part at the 71st Annual Meeting of the International Anesthesia Research Society.
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Splinter, W.M., Roberts, D.J. Perphenazine decreases vomiting by children after tonsillectomy. Can J Anaesth 44, 1308–1310 (1997). https://doi.org/10.1007/BF03012781
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DOI: https://doi.org/10.1007/BF03012781