Effect of transdermal hyoscine on nausea and vomiting after surgical correction of prominent ears under general anaesthesia

A 0.5-mg transdermal hyoscine patch reduced vomiting from 48% to 16% versus placebo.

“Honkavaara et al18 reported that a 0.5-mg transdermal hyoscine patch reduced vomiting from 48% to 16% versus placebo, but produced short-lived blurred vision, dizziness, and bradycardia in less than 10% of children, almost all resolving within 2 hours, except for 1 case.”

Transdermal hyoscine patches and maintenance anesthesia with propofol each reduced vomiting rates by about one-half relative to placebo or thiopentone/isoflurane, respectively.

“Transdermal hyoscine patches18 and maintenance anesthesia with propofol19 each reduced vomiting rates by about one-half relative to placebo or thiopentone/isoflurane, respectively.”

The hyoscine patch produced short-lived blurred vision, dizziness, and bradycardia in less than 10% of children, almost all resolving within 2 hours, except for 1 case.

“Honkavaara et al18 reported that a 0.5-mg transdermal hyoscine patch reduced vomiting from 48% to 16% versus placebo, but produced short-lived blurred vision, dizziness, and bradycardia in less than 10% of children, almost all resolving within 2 hours, except for 1 case.”

Cervical plexus blocks occasionally produced mild hoarseness or self-limiting Horner syndrome-like symptoms.

“Cervical plexus blocks occasionally produced mild hoarseness or self-limiting Horner syndrome–like symptoms,1 and hyoscine patches were associated with brief visual disturbance or bradycardia in a small number of children.18”

No permanent complications were reported.

“however, no permanent complications were reported.1,18”

The favorable safety signal for transdermal hyoscine derives from just 1 pediatric RCT.

“Finally, the single lidocaine-versus-bupivacaine trial is subject to “duration bias,” as distinct Na⁺-channel binding kinetics confound any anatomical effect, and the favorable safety signal for transdermal hyoscine derives from just 1 pediatric RCT.”

Hyoscine patches produced reversible anticholinergic effects (blurred vision, dry mouth, dizziness) in a minority of children.

“Conversely, hyoscine patches, though effective, produced reversible anticholinergic effects (blurred vision, dry mouth, dizziness) in a minority of children.18”