British Journal of Anaesthesia 89 (3): 473-8 (2002) Management of post-strabismus nausea and vomiting in children using ondansetron: a value-based comparison of outcomes1^

Background. This study evaluated the clinical efficacy and cost-effectiveness of prophylactic ondansetron versus early ondansetron treatment in the management of postoperative nausea and vomiting (PONV) in children undergoing strabismus repair using clinically meaningful out-comes and value-based principles. Methods. One hundred and fifty children were randomly assigned to either prophylactic (P) or early symptomatic treatment only (T) group (n=75). Children in group P received ondanse-tron 100 fig kg"1 i.v. and those in group T received placebo at the end of the procedure. After surgery, at the earliest sign of nausea or vomiting, children in both groups received ondanse-tron 100 (ig kg"1 i.v. Besides the incidence of PONV, non-surrogate (fast tracking time, duration of stay in the postanaesthesia care unit (PACU) and parental satisfaction scores), therapeutic (numbers needed to prevent and treat) and pharmacoeconomic (cost to benefit a child and cost per PONV-free child) outcome measures were evaluated. Results. The incidences of PONV in the immediate, early, late and first 24-h periods were sig