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Anesth Analg 2002;94:50-54
© 2002 International Anesthesia Research Society

PEDIATRIC ANESTHESIA

Cisapride Does Not Prevent Postoperative Vomiting in Children

Scott D. Cook-Sather, MD, Kathleen A. Harris, RN BSN, and Mark S. Schreiner, MD

Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, and the University of Pennsylvania, Philadelphia, Pennsylvania

Address correspondence and reprint requests to Scott D. Cook-Sather, MD, Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, 34th St. and Civic Ctr. Blvd., Philadelphia, PA 19104. Address e-mail to sather@ email.chop.edu.

The peripherally acting prokinetic drug cisapride can overcome opioid-induced gastrointestinal paresis and may thereby eliminate a stimulus for postoperative vomiting. We conducted a prospective, randomized, double-blinded, controlled trial of 96 children undergoing inguinal surgery to determine whether cisapride would reduce the incidence of postoperative vomiting after general anesthesia supplemented with morphine. Group C1 patients (n = 38) received cisapride 0.3 mg/kg orally 1 h before surgery and placebo 6 h later, Group C2 (n = 28) received cisapride both before and after surgery, and Group P (n = 30) received placebo. Mean age (5.0 ± 2.7 yr) and weight (21.0 ± 8.6 kg), median pain scores and parent satisfaction scores, and incidence of rescue analgesic administration were similar across groups. Contrary to our hypothesis, incidences of postoperative vomiting in the hospital (32% vs 20%, P = 0.33) and at home (53% vs 46%, P = 0.33) did not vary by treatment group (with [C1 and C2] and without [P] cisapride, respectively). There was a trend toward more severe postoperative vomiting (three or more episodes) in children who received cisapride versus those who did not, both in hospital (6% vs 0%, P = 0.3) and at home (22% vs 8%) (P = 0.13). We conclude that cisapride does not prevent postoperative vomiting in this patient population and speculate that factors other than reduced gastrointestinal motility associated with general anesthesia and opioids are more important determinants of postoperative vomiting.

IMPLICATIONS: Cisapride does not prevent postoperative vomiting in children and may increase its severity.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2002 by the International Anesthesia Research Society.