Preoperative ondansetron lozenge for prevention of postoperative nausea and vomiting in pediatrics undergoing squint surgeries: a randomized controlled trial

BACKGROUND: Postoperative nausea and vomiting (PONV) remain a significant clinical challenge in pediatric squint surgeries, with potential serious complications. This randomized controlled trial aimed to evaluate the efficacy of preoperative ondansetron lozenges in preventing PONV among pediatric patients undergoing squint surgeries. METHODS: Eighty pediatric patients (aged 4-15 years) undergoing squint surgeries were randomly assigned to two equal groups: Group S received 4 mg ondansetron lozenge for two hours preoperatively, while Group C served as the control. RESULTS: The ondansetron lozenge group demonstrated significantly lower PONV incidence (22.5% vs. 52.5%, P=0.006, with relative risk (RR) of 0.43 (95% CI 0.22:0.82), with reduced severity across 0-2-, 2-12-, and 12-24-hour intervals. Time to onset of emesis was prolonged (269.11±214.87 vs. 115.24±65.68, P=0.005), and the oculocardiac reflex incidence was reduced (12.5% vs. 37.5%, P=0.018). Parental satisfaction was significantly higher in the Ondansetron group (8.95±1.38 vs. 7.83±1.99, P=0.004). CONCLUSIONS: Preoperative ondansetron lozenges effectively reduce PONV incidence, severity, and complications in pediatric squint surgery, suggesting a promising prophylactic intervention.