[Prophylactic effect of diphenhydramine on postoperative vomiting in children after laparoscopic surgery].

BACKGROUND: Laparoscopic percutaneous extraperitoneal closure (LPEC), introduced as an alternative to a conventional open inguinal hernia repair in children, has shown a higher incidence of postoperative vomiting (POV). The aim of this study was to examine whether a prophylactic use of diphenhydramine can decrease the incidence of POV in children undergoing LPEC. METHODS: We studied 60 girls between 1 and 6 years of age with ASA physical status I or II undergoing LPEC. Patients were allocated to receive either diphenhydramine 1 mg x kg(-1) intravenously (n = 30) or placebo (n = 30) during the operation. Anesthesia was performed with air-oxygen-sevoflurane in combination with epidural anesthesia. Opioids were avoided throughout the perioperative period. The incidence of POV was recorded postoperatively. RESULTS: Demographic data were similar between the groups. The overall incidence of POV during the first 24 postoperative hours was significantly higher in the placebo group (56.7%) than in the diphenhydramine (6.7%) group (P < 0.01). The wake-up in the ward was significantly prolonged in the diphenhydramine group than control group. CONCLUSIONS: Prophylactic use of diphenhydramine substantially reduced the risk of postoperative vomiting, but was associated with prolonged sedation in pediatric patients undergoing LPEC.