Post-Operative Nausea and Vomiting in Children Submitted to Strabismus Surgery

Sponsor
Universidade Federal Fluminense (Other)
Overall Status
Unknown status
CT.gov ID
NCT04060771
Collaborator
(none)
80
1
2
23
3.5

Study Details

Study Description

Brief Summary

Background: Postoperative nausea and vomiting (PONV) is one of the main causes of patient and family dissatisfaction, which may delay the onset of oral intake and postpone discharge. In pediatric patients, the incidence of PONV is high, and in some studies it can reach values of 70%. Strabismus surgery is considered an independent risk factor for PONV. Palonosetron is a second generation antiemetic drug, 5-hydroxytryptamine receptor antagonist, with a long half-life, which allows single dose administration and has been shown to be safe and effective in the treatment of chemotherapy induced nausea and vomiting, and has been used with satisfactory results in the prophylaxis of PONV in adult and pediatric patients. Studies involving palonosetron are still scarce.

Condition or Disease Intervention/Treatment Phase
Phase 3

Detailed Description

Prospective, double-blind study comparing Palonosetron and Dexamethasone in the prophylaxis of Post-Operative Nausea and Vomiting in children submitted to Strabismus surgery ABSTRACT Background: Postoperative nausea and vomiting (PONV) is one of the main causes of patient and family dissatisfaction, which may delay the onset of oral intake and postpone discharge. In pediatric patients, the incidence of PONV is high, and in some studies it can reach values of 70%. Strabismus surgery is considered an independent risk factor for PONV. Palonosetron is a second generation antiemetic drug, 5-hydroxytryptamine receptor antagonist, with a long half-life, which allows single dose administration and has been shown to be safe and effective in the treatment of chemotherapy induced nausea and vomiting, and has been used with satisfactory results in the prophylaxis of PONV in adult and pediatric patients. Studies involving palonosetron are still scarce.

Objective: The study aims to compare the incidence of PONV after intravenous administration of palonosetron or dexamethasone in pediatric patients undergoing elective strabismus surgery under general anesthesia.

Materials and Methods: This prospective, double-blind study consist of 80 patients of both genders, classified as ASA grade I and II, ranging in age from 2 to 15 years, scheduled for elective strabismus surgery at Hospital Universitário Antonio Pedro(HUAP), after consent by their parents. Patients will be randomized into two groups of 40 patients each. Group P will receive intravenous dose of palonosetron (1 mg.kg-1), and Group D will receive dexamethasone (0.2 mg.kg-1) after induction of anesthesia. Pacients will be observed for 6 hours before discharge and post-discharge symptoms will be assessed through telephone survey after 24 and 48 hours. At the end of the study, results will be compiled and statistical analysis will be done by using Mann-Whitney test, Chi-squared test and Fisher test.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
80 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Intervention Model Description:
Patients will be divided between two groups, Group P will receive single dose of palonosetron whereas Group D will receive a single dose of dexamethasone during general anesthesia.Patients will be divided between two groups, Group P will receive single dose of palonosetron whereas Group D will receive a single dose of dexamethasone during general anesthesia.
Masking:
Double (Participant, Investigator)
Masking Description:
Double-blinded
Primary Purpose:
Prevention
Official Title:
Prospective, Double-blind Study Comparing Palonosetron and Dexamethasone in the Prophylaxis of Post-Operative Nausea and Vomiting in Children Submitted to Strabismus Surgery
Actual Study Start Date :
Aug 1, 2018
Anticipated Primary Completion Date :
Nov 1, 2019
Anticipated Study Completion Date :
Jul 1, 2020

Arms and Interventions

Arm Intervention/Treatment
Experimental: Group P

During general anesthesia patients will receive a single intravenous dose of palonosetron 1 mcg.Kg-1.

Drug: Palonosetron
prophylaxis of postoperative nausea and vomiting
Other Names:
  • Prophylactic
  • Active Comparator: Group D

    During general anesthesia patients will receive a single intravenous dose of dexamethasone 0.2 mg.Kg-1.

    Drug: Dexamethasone
    prophylaxis of postoperative nausea and vomiting
    Other Names:
  • Prophylactic
  • Outcome Measures

    Primary Outcome Measures

    1. Vomiting [48 hours postoperative]

      Quantify the frequency of individual episodes of vomiting at the first 48 hours after surgery.

    Secondary Outcome Measures

    1. Vomiting [24 hours postoperative]

      Quantify the frequency of individual episodes of vomiting at the first 24 hours after surgery.

    2. Vomiting [6 hours postoperative]

      Quantify the frequency of individual episodes of vomiting at the first 6 hours after surgery.

    3. Vomiting [2 hours postoperative]

      Quantify the frequency of individual episodes of vomiting at the first 2 hours after surgery.

    4. Nausea [48 hours postoperative]

      Quantify the frequency of episodes of nausea at the first 48 hours after surgery.

    5. Nausea [24h hours postoperative]

      Quantify the frequency of episodes of nausea at the first 24 hours after surgery.

    6. Nausea [6h hours postoperative]

      Quantify the frequency of episodes of nausea at the first 6 hours after surgery.

    7. Nausea [2h hours postoperative]

      Quantify the frequency of episodes of nausea at the first 2 hours after surgery.

    8. Check adverse effects [48 hours postoperative]

      Check the frequency of adverse events (headache, dizziness, drowsiness).

    9. Treatment cost [48 hours postoperative]

      Price evaluation of antiemetic drugs.

    10. Response to medication [48 hours postoperative]

      Quantify the number of complete responders (individuals who did not have an episode of PONV and did not require rescue medication).

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    2 Years to 15 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • Children undergoing elective strabismus surgery

    • Physical state according to an American Society of Anesthesiologists (ASA) I and II

    Exclusion Criteria:
    • Children nor involved in surgery

    • Participation in another study in the last month

    • Previous history of PONV

    • Occurrence of episodes of nausea or vomiting in the last 24 hours before surgery

    • Chronic use of corticosteroids

    • Previous history of motion sickness

    • Use of psychoactive drugs or any other medicine with an antiemetic effect;

    • Known hypersensitivity to any study medication

    • Severe diseases in organs such as kidney, liver, lung, heart, brain and bone marrow

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Hospital Universitário Antonio Pedro Niterói Rio De Janeiro Brazil 24033900

    Sponsors and Collaborators

    • Universidade Federal Fluminense

    Investigators

    • Principal Investigator: Júlio CA Moreira, MD, Hospital Universitário Antonio Pedro

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Alexandra Rezende Assad, PhD, Professor, Universidade Federal Fluminense
    ClinicalTrials.gov Identifier:
    NCT04060771
    Other Study ID Numbers:
    • Strabismus surgery
    First Posted:
    Aug 19, 2019
    Last Update Posted:
    Aug 19, 2019
    Last Verified:
    Aug 1, 2019
    Studies a U.S. FDA-regulated Drug Product:
    No
    Studies a U.S. FDA-regulated Device Product:
    No
    Product Manufactured in and Exported from the U.S.:
    No
    Keywords provided by Alexandra Rezende Assad, PhD, Professor, Universidade Federal Fluminense
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of Aug 19, 2019