The frequent incidence of postoperative vomiting and severe pain in children undergoing adenotonsillectomy, may delay postoperative oral intake and increase the risk of dehydration. Postoperative nausea and vomiting (PONV) is of multi-factorial origin in this group of patients, with a reported incidence ranging from 23% to 73%. There is growing evidence that the perioperative administration of gabapentinin in adults is beneficial for preoperative anxiolysis, postoperative analgesia, reduction of postoperative nausea and vomiting, and delirium. Only few studies in literature explored the analgesic effects of preoperative gabapentin as premedication in pediatric population. However, the antiemetic effect of gabapentin in pediatric patients was not systematically investigated before.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
QUADRUPLE
Enrollment
140
Patients will receive 0.3 ml/kg (16 mg/kg) oral gabapentin solution (Neurontin 50 mg/ml, Pfizer Pharmaceutical) as premedication two hours before the induction of anesthesia
Patients will receive 0.3 ml/kg of a placebo solution identical in taste, shape and color to the study medication two hours before the induction of anesthesia.
Kasr Al Ainy
Cairo, Egypt
Incidence of PONV
The number of patient complaints of nausea and or vomiting will be recorded in the first 6 hours postoperatively
Time frame: over the first postoperative 6 hours
Pediatric Anesthesia Behavior score (PAB)
the score will be assessed during induction of anesthesia. The child will be scored 1 if Happy; 2 if Sad; and 3 if Mad.
Time frame: within10 minutes before the child falls asleep.
Incidence and severity of postoperative delirium
Emergence agitation scores will be recorded every10 min for the first 60 minutes postoperatively
Time frame: up to 60 minutes after the end of the operation.
Duration of recovery
The extubation time will be the time interval from discontinuation of sevoflurane until removal of the endotracheal tube. The time to interaction will be the time from discontinuation of sevoflurane until verbal contact or response to commands.
Time frame: up to 60 minutes after the end of surgery.
Time to first request of postoperative rescue analgesics.
the time interval between the end of surgery and the first request to postoperative analgesia
Time frame: over the first postoperative 6 hours
Postoperative analgesic consumption
Time frame: over the first postoperative 6 hours
Objective pain scale (OPS)
The objective pain scale will be assessed at 30 minutes, 2, 4 and 6 hours postoperatively.
Time frame: over the first postoperative 6 hours
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