Guided Imagery for Postoperative Pain, Energy Healing for Quality of Life, Probiotics for Acute Diarrhea in Children, Acupuncture for Postoperative Nausea and Vomiting, and Animal-Assisted Therapy for Mental Disorders

Purpose: To date, no protocol of anesthesia for pediatric ophthalmic surgery is unanimously recognized. The primary anesthetic risks are associated with strabismus surgery, including oculocardiac reflex, postoperative nausea and vomiting, and postoperative pain. Methods: This was a prospective, monocentric, observational study conducted in a tertiary pediatric ophthalmic unit. Our anesthetic protocol for strabismus surgery included postoperative nausea and vomiting prevention using dexamethasone and ondansetron. No drug-based prevention of oculocardiac reflex or local/locoregional anesthesia was employed. Results: A total of 106 pediatric ophthalmic surgeries completed between November 2015 and May 2016 were analyzed. The mean patient age was 4.4 (range: 0.2–7.3, standard deviation: 2.4) years. Ambulatory rate was 90%. Oculocardiac reflex incidence was 65% during strabismus surgery (34/52), 50% during congenital cataract surgery (4/8), 33% during intramuscular injection of botulinum toxin (1/3), and 0% during other procedures. No asystole occurred. Postoperative nausea and vomiting incidence was 9.6% after strabismus surgery (5/52) and 0% following the other procedures. One child was hospitalized for one night because of persistent postoperative nausea and vomiting. Postoperative pain generally occurred early on in the recovery room and was quickly controlled. Its incidence was higher in patients who underwent strabismus surgery (27%) than in those who underwent other procedures (9%). Conclusion: Morbidity associated with ophthalmic pediatric surgery is low and predominantly associated with strabismus surgery. The benefit–risk ratio and cost-effectiveness of oculocardiac reflex prevention should be questioned. Our postoperative nausea and vomiting rate is low, thanks to the use of a well-managed multimodal strategy. Early postoperative pain is usually well-treated but could probably be more effectively prevented.

Download Full-text

Efficacy of Three Different Prophylactic Treatments for Postoperative Nausea and Vomiting after Vitrectomy: A Randomized Clinical Trial

Journal of Clinical Medicine ◽

10.3390/jcm8030391 ◽

2019 ◽

Vol 8 (3) ◽

pp. 391 ◽

Cited By ~ 5

Author(s):

Michele Reibaldi ◽

Matteo Fallico ◽

Antonio Longo ◽

Teresio Avitabile ◽

Marinella Astuto ◽

...

Keyword(s):

Clinical Trial ◽

Postoperative Pain ◽

Adverse Events ◽

Local Anesthesia ◽

Postoperative Nausea ◽

Therapy Group ◽

Combined Therapy ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Combination Group

Postoperative nausea and vomiting (PONV) after vitreoretinal surgery may potentially be associated with severe complications, such as suprachoroidal hemorrhage. The purpose of the present multicenter clinical trial (NCT02386059) was to assess the efficacy of three different prophylactic treatments for PONV after vitrectomy under local anesthesia. Patients undergoing primary vitrectomy were randomized to the control arm or to one of the treatment arms (4 mg ondansetron, 4 mg dexamethasone, combination of the two drugs). The primary outcome measure was the proportion of complete response (no nausea, no vomiting, no retching, and no use of antiemetic rescue medication) during 24 h after vitrectomy. Secondary outcomes included the severity standardized score of PONV, postoperative pain standardized score, and rate of ocular and non-ocular adverse events. Baseline demographics of the 1287 patients were comparable between the four arms. The combined therapy group showed a statistically significant lower incidence of PONV compared to the placebo and monotherapy (p < 0.001). PONV severity was also reduced in the combination group compared to the others (p < 0.001). Postoperative pain scores and adverse events were comparable among the four groups. Combined therapy with dexamethasone and ondansetron was the most effective treatment for reducing the incidence and severity of PONV in patients undergoing vitrectomy under local anesthesia.

Download Full-text

IPMO Guidelines; Improved Perioperative Management and Outcomes Postoperative Pain Management and Postoperative Nausea and Vomiting Management

THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA ◽

10.2199/jjsca.30.410 ◽

2010 ◽

Vol 30 (3) ◽

pp. 410-419

Author(s):

Masahiro TAKAHASHI ◽

Aya NISHIMURA ◽

Hitoshi FURUYA

Keyword(s):

Pain Management ◽

Postoperative Pain ◽

Postoperative Nausea ◽

Perioperative Management ◽

Postoperative Nausea And Vomiting ◽

Postoperative Pain Management ◽

Nausea And Vomiting

Download Full-text

Re: Comparison of different hypotensive anaesthesia techniques in orthognathic surgery with regard to intraoperative blood loss, quality of the surgical field, and postoperative nausea and vomiting

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2017.06.029 ◽

2017 ◽

Vol 46 (10) ◽

pp. 1352-1353

Author(s):

S. Lin ◽

C. Chen ◽

Y.-R. Chen

Keyword(s):

Blood Loss ◽

Postoperative Nausea ◽

Orthognathic Surgery ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Intraoperative Blood Loss ◽

Hypotensive Anaesthesia ◽

Surgical Field

Download Full-text

Comparison of Acustimulation and Ondansetron for the Treatment of Established Postoperative Nausea and Vomiting

Anesthesiology ◽

10.1097/00000542-200212000-00009 ◽

2002 ◽

Vol 97 (6) ◽

pp. 1387-1392 ◽

Cited By ~ 46

Author(s):

Margarita Coloma ◽

Paul F. White ◽

Babatunde O. Ogunnaike ◽

Scott D. Markowitz ◽

Philip M. Brown ◽

...

Keyword(s):

Patient Satisfaction ◽

Postoperative Nausea ◽

Response Rate ◽

Complete Response Rate ◽

Postoperative Nausea And Vomiting ◽

Complete Response ◽

Nausea And Vomiting ◽

Combination Group ◽

Quality Of Recovery

Background This study was designed to evaluate transcutaneous electrical acupoint stimulation (acustimulation) using the ReliefBand compared with ondansetron for the treatment of established postoperative nausea and vomiting (PONV) after outpatient laparoscopic surgery. Methods After the authors obtained institutional review board approval and written informed consent, 268 outpatients were enrolled in this randomized, double-blind, placebo- and sham-controlled study. All patients received antiemetic prophylaxis with metoclopramide, 10 mg intravenously, or droperidol, 0.625 mg intravenously, after induction of anesthesia. A total of 90 patients developed PONV in the recovery units and were randomized to one of three treatment groups: (1) the ondansetron group received 4 mg intravenous ondansetron and a sham ReliefBand; (2) the acustimulation group received 2 ml intravenous saline and a ReliefBand; and (3) the combination group received 4 mg intravenous ondansetron and a ReliefBand. A rescue antiemetic (10 mg intravenous metoclopramide) was administered only if the PONV symptoms persisted for 15 min or longer after initiating the treatment. A blinded observer recorded the recovery times, emetic symptoms, rescue antiemetics, maximum nausea scores, complete response to study treatment, and time to achieve discharge criteria. Postdischarge side effects, as well as patient satisfaction and quality of recovery scores, were assessed at 24 and 72 h after surgery. Results The combination group had a significantly higher complete response rate than the acustimulation group (73% vs.40%, P <0.01). In addition, fewer patients (8 vs. 18) in the combination (vs. acustimulation) group experienced subsequent emetic events (P < 0.03). However, there were no significant differences between the three groups with respect to patient satisfaction and quality of recovery scores. Conclusions Acustimulation with the ReliefBand can be used as an alternative to ondansetron for the treatment of established PONV. However, the use of ondansetron (4 mg intravenously) in combination with the ReliefBand device improved the complete response rate to the acustimulation therapy.

Download Full-text