Ondansetron Versus Droperidol or Placebo to Prevent Nausea and Vomiting after Otologic Surgery

1998 ◽  
Vol 118 (6) ◽  
pp. 785-789 ◽  
Author(s):  
W. SCOTT JELLISH ◽  
JOHN P. LEONETTI ◽  
ELAINE FLUDER ◽  
ZUHAIR THALJI
Keyword(s):  
Saline Solution ◽  
Nausea And Vomiting ◽  
Postanesthesia Care Unit ◽  
Anesthetic Induction ◽  
Otologic Surgery ◽  
Preoperative Administration ◽  
To Receive ◽  
Head Neck ◽  
Rescue Antiemetic ◽  
Better Than

This study compares the preoperative administration of ondansetron with that of droperidol or saline solution for the prevention of nausea and vomiting in otologic surgery patients. A total of 120 otherwise healthy individuals were randomly assigned to receive either saline solution, ondansetron (4 mg intravenously), or droperidol (25 μg/kg intravenously) before anesthetic induction. Intraoperative and postanesthesia care unit times were recorded along with incidence of nausea, vomiting, pain, nausea and recovery scores, and the administration of rescue antiemetics. Similar assessments were made during the next 24 hours. Demographics were similar, but more males received ondansetron. Anesthetic recovery scores were lower after administration of droperidol than after ondansetron. Incidence of nausea was similar between groups, but severity was greater with placebo and droperidol than with ondansetron. More vomiting occurred with placebo than with ondansetron or droperidol. No intergroup differences in rescue antiemetic administration were noted, however. Twenty-four hours later, more patients receiving placebo had nausea or vomited than patients receiving droperidol or ondansetron. Fewer women in the ondansetron group vomited than in the other two groups. Ondansetron 4 mg intravenously is as effective as droperidol and better than saline solution in preventing nausea and vomiting in patients undergoing otologic surgery. No cost advantage as determined by lower use of rescue antiemetics or shorter postanesthesia care unit times was noted after ondansetron therapy. (Otolaryngol Head Neck Surg 1998;118:785–9.)

scholarly journals Lack of Efficacy of Propofol in the Treatment of Early Postoperative Nausea and Vomiting

1998 ◽  
Vol 26 (4) ◽  
pp. 366-370 ◽  
Author(s):  
I. Harper ◽  
E. Della-Marta ◽  
H. Owen ◽  
J. Plummer ◽  
A. Ilsley
Keyword(s):  
Low Dose ◽  
Dose Range ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Test Drug ◽  
Gynaecological Surgery ◽  
Treatment Groups ◽  
Sedation Scores ◽  
To Receive ◽  
Rescue Antiemetic

The anti-nauseant efficacy of low-dose propofol was investigated in a blinded, randomized trial. Patients who complained of nausea and/or vomiting following laparoscopic gynaecological surgery and who requested antiemetic were randomly assigned to receive placebo, propofol 3 mg, propofol 9 mg or propofol 27 mg by intravenous injection. Nausea, vomiting and sedation were recorded by a blinded observer for 90 minutes following administration of the test drug, prior to discharge, and 24 hours following surgery. Rescue antiemetic (droperidol 1.0 mg IV) was available from 10 minutes after administration of test drug. Propofol failed to reduce nausea scores and did not reduce the incidence of vomiting. Numbers of patients receiving rescue antiemetic were similar in the four treatment groups. In the first 10 minutes following test drug administration, sedation scores were increased by propofol in a dose-related manner. We conclude that, in the dose range studied, propofol is ineffective for the treatment of nausea and vomiting occurring soon after laparoscopic gynaecological surgery.

scholarly journals COMPARISION OF ONDANSETRON VERSUS DEXAMETHASONE FOR PREVENTION OF NAUSEAAND VOMITING IN DIAGNOSTIC LAPAROSCOPIC GYNAECOLOGICAL PROCEDURES

2020 ◽  
pp. 18-23
Author(s):  
Parasmani Parasmani ◽  
Joshi Nirali K. ◽  
Nehal Chandra ◽  
Mukesh I. Shukla
Keyword(s):  
Side Effects ◽  
General Anaesthesia ◽  
Pain Score ◽  
Nausea And Vomiting ◽  
Gynaecological Laparoscopy ◽  
Ethical Committee Approval ◽  
Post Operative Nausea ◽  
Group D ◽  
Rescue Antiemetic ◽  
Better Than

BACKGROUND: Post-operative nausea and vomiting (PONV) affects 30-40% of patients after general anaesthesia.[11] AIMS: To compare the effect of Ondansetron and Dexamethasone for prevention of nausea and vomiting in diagnostic gynaecological laparoscopy. METHODS: Ethical committee approval was taken. Consent was obtained. Patients were divided into 2 groups of 30 each. General anaesthesia was administered to all patients. Inj. Ondansetron 0.15 mg/kg i.v. was given to patients of group O. Injection Dexamethasone 0.2 mg/kg IV was given to patients of group D. Patients were monitored for nausea, vomiting, retching, pain score, side effects and requirement of rescue antiemetic. RESULTS: Inj. Dexamethasone is better than Inj. Ondansetron for prevention of P.O.N.V. in diagnostic gynaecological laparoscopy.

scholarly journals LAPAROSCOPIC CHOLECYSTECTOMY;

2013 ◽  
Vol 20 (05) ◽  
pp. 699-706
Author(s):  
HEMMATPOOR BEHZAD ◽  
MAHVAR TAYEBEH ◽  
MAKHSOSI BEHNAM REZA ◽  
Saeb Morteza
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Shoulder Pain ◽  
Rating Scale ◽  
Controlled Study ◽  
P Value ◽  
Medical Sciences ◽  
Preoperative Administration ◽  
Elective Laparoscopic Cholecystectomy ◽  
Double Blinded ◽  
To Receive

Background: shoulder pain after laparoscopic procedure is a frequent complication encountered in surgery ward. Severaltreatments have been proposed to reduce it. This study aimed to evaluate the efficacy of preoperative administration of gabapentin inpreventing and attenuating Post Laparoscpoic Shoulder Pain (PLSP) after laparoscopic cholecystectomy. Design: In a randomised,double blinded placebo controlled study. Setting: Woman's Hospital, Kermanshah University of Medical Sciences. Period: April 2011 toMarch 2012. Material and methods: 90 patients of ASA physical status I-II undergoing elective laparoscopic cholecystectomy wererandomly allocated to receive gabapentin 600 mg or placebo ,half an hour before surgery. The presence analgesia and side effects wererecorded for 12h postoperatively in same times. Results: Incidence Verbal Rating Scale (VRS) ≥ 4 at different times after arrival to PACUwere significantly lower in gabapentin group in arrival (P Value= 0.003) and then after 30 miniute (P Value= 0.02) and 2 (P Value=0.003), 4 (P Value= 0.03) and 6 (P Value= 0.04) hours after arrival to Post Anesthesia Care Unit (PACU). But this sigificancy lost at 12hours (P Value= 0.07) after arrival to PACU. Also there was a reduction in amounts of postoperative in ward analgesic consumption. Sideeffects were not different between two groups. Conclusions: 600 mg gabapentin as premedication is effective and safe for reducing postlaparoscopicshoulder pain intensity after general laparoscopy compared with placebo.

Pirenzepine in Non-Ulcer Dyspepsia: A Double-Blind Multicentre Trial

1990 ◽  
Vol 18 (1) ◽  
pp. 16-20 ◽  
Author(s):  
P.M. Smith ◽  
A.H. Troughton ◽  
F. Gleeson ◽  
J. Walters ◽  
C.F. McCarthy
Keyword(s):  
Abdominal Pain ◽  
Placebo Group ◽  
Adverse Effects ◽  
Multicentre Study ◽  
Multicentre Trial ◽  
Nausea And Vomiting ◽  
Double Blind ◽  
Non Ulcer Dyspepsia ◽  
Upper Abdominal ◽  
To Receive

In a double-blind multicentre study to compare pirenzepine with placebo in non-ulcer dyspepsia, 71 patients were randomized to receive 50 mg pirenzepine or placebo given orally twice daily for 4 weeks. The trial was not completed by five patients in the pirenzepine group and six in the placebo group. There were no significant differences between the groups in respect to changes in total symptoms (upper abdominal pain, nausea and vomiting, early satiety and postprandial bloating, eructation and pyrosis) scores and outcome, although 27/35 (77%) patients receiving pirenzepine were cured or improved compared with 22/36 (61%) receiving the placebo. Adverse effects were reported by 13 (37%) patients treated with pirenzepine and by six (17%) treated with placebo, seven withdrawing due to adverse effects.

A phase III, randomized, double-blind, multicenter, active control study of fosnetupitant for the prevention of chemotherapy-induced nausea and vomiting (CINV) in patients receiving cisplatin-based highly emetogenic chemotherapy (HEC): CONSOLE.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12099-12099
Author(s):  
Yoshimasa Shiraishi ◽  
Akito Hata ◽  
Naoki Inui ◽  
Morihito Okada ◽  
Masahiro Morise ◽  
...  
Keyword(s):  
Study Drug ◽  
Incidence Rates ◽  
Emetogenic Chemotherapy ◽  
Nausea And Vomiting ◽  
Phase Iii ◽  
Highly Emetogenic Chemotherapy ◽  
Double Blind ◽  
Secondary Endpoints ◽  
To Receive ◽  
Age Category

12099 Background: Fosnetupitant (FN) is a phosphorylated pro-drug of netupitant that has high binding affinity for the neurokinin-1 (NK-1) receptor and a long half-life of 70 h. This phase 3 study is the first head-to-head study to compare two NK-1 receptor antagonists, FN and fosaprepitant (FA), in combination with palonosetron and dexamethasone for the prevention of chemotherapy-induced nausea and vomiting (CINV) in patients receiving highly emetogenic chemotherapy (JapicCTI-194611). Methods: Patients scheduled to receive cisplatin (≥70 mg/m2) -based chemotherapy were randomly assigned 1:1 to receive FN 235 mg or FA 150 mg, in combination with palonosetron 0.75 mg and dexamethasone (9.9 mg on day 1, 6.6 mg on days 2-4). The stratification factors were sex, age category (<55 vs. ≥55 years), and site. The primary endpoint was the complete response (CR; no emetic events and no rescue medication) rate, stratified by sex and age category, during the overall phase (0-120 h) to show the non-inferiority (margin, -10%) of FN to FA. The secondary endpoints were: CR rate, complete protection rate, total control rate, no nausea rate, no emetic events rate in each period [i.e., acute (0-24 h), delayed (24-120 h), overall, 0-168 h and 120-168 h], time to treatment failure, and safety, including injection site reactions (ISRs). Assessment of efficacy was continued until 168 h after the initiation of cisplatin. Some eligible patients were evaluated for safety and efficacy of FN for up to four cycles. Results: Between February 2019 and March 2020, total 795 patients were enrolled in the study. The study drug was administered to 785 patients (n=392 in FN vs. n=393 in FA), and all of them were evaluated for efficacy and safety. Baseline characteristics were generally balanced between the two groups. The adjusted overall CR rate was 75.2% in FN vs. 71.0% in FA [MH common risk difference, 4.1%; 95% CI, -2.1% to 10.3%), thus demonstrating non-inferiority of FN to FA. Regarding the other secondary endpoints of efficacy until 168 h, FN was favorable against FA, especially the CR rate during 0-168 h (73.2% in FN vs. 66.9% in FA) (Table). The incidence rates of treatment-related adverse events were 22.2% in FN vs. 25.4% in FA, whereas those of ISRs with any cause or with treatment-related were 11.0% or 0.3% in FN vs 20.6% or 3.6% in FA, respectively ( p<0.001). Conclusions: FN demonstrated non-inferiority to FA, with a favorable safety profile and lower risk for ISRs. For the period beyond 120 h after initiation of chemotherapy, FN may have the potential to improve the prevention of “beyond delayed” CINV. Clinical trial information: JapicCTI-194611. [Table: see text]

Editorial

2008 ◽  
Vol 7 (3) ◽  
pp. 106-106
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
Case Reports ◽  
Coding System ◽  
Alert System ◽  
The Past ◽  
Cerebral Nocardiosis ◽  
Irritable Bowel ◽  
Lateral Thinking ◽  
Difficult Times ◽  
To Receive ◽  
Better Than

There is no doubt that this Winter has been tough for those of us working in Acute Medical Units. At the time of writing I find myself in the depths of the post-Christmas blues; the combination of Bank Holidays, ward closures, junior doctor illness and huge admission surges have conspired to make January even more challenging than normal. No doubt the printing delays will have meant that, by the time you are reading this Editorial, these days will be a distant memory. Maybe this will serve as a useful reminder of the need for forward planning in time for next year, rather than breathing the usual sigh of relief as we steel ourselves for Easter. Perhaps a more imaginative colour coding system for our ‘alert’ system would be a start – simply alternating between ‘red alert’ (awful) and ‘black alert’ (even worse) can become quite tedious as the weeks pass. A few shades of maroon or magenta to remind us that ‘today is slightly better than yesterday’ might help break the monotony. We could even opt for a full rainbow spectrum to signify the hope that one day all of our efforts will be worthwhile….it’s important to stay positive in these difficult times! I frequently tell our students ‘When you hear hooves, think horses…not zebras’ – an alternative (and unoriginal) way to remind them that ‘common things occur commonly’. But of course not all chest pain is ischaemic in origin, and not every fever is caused by pneumonia – even in January. The case reports in this edition illustrate some of the more unusual causes of acute medical admission, and the importance of maintaining an open mind. Takotsubo cardiomyopathy is a condition which seems to have passed me by in my medical practice to-date; on reading this case I wondered how many patients I have inappropriately thrombolysed over the past 15 years. In the new world of Heart Attack Centres and urgent percutaneous intervention maybe we will find it is more common than was previously thought. Porphyrias and vasculitidies are occasionally sent to challenge us, but give us the opportunity to demonstrate the power of lateral thinking which distinguishes us as Physicians. As the authors remind us in their title – porphyria will only be diagnosed if it is considered in the differential; it is easy forget that the combination of psychiatric illness and abdominal pain does not always imply Irritable Bowel Syndrome! Cerebral Nocardiosis should not feature high up in the differential diagnosis when a 90 year old patient presents with a hemiparesis, even in the context of immune deficiency. The temptation to presume that the ‘ring enhancing lesion’ seen on his CT was neoplastic, must have been considerable for the team caring for this patient. The importance of a tissue diagnosis, even in this age group, is emphasised by the outcome of this case. I hope you enjoy this edition and hopefully we are now getting back on track with the scheduling. Please keep the submissions coming in; we are starting to receive some interesting pieces of research, which will be included over the next year pending review. If any more readers would like to volunteer to become editorial referees for future editions, please feel free to contact me directly on the email shown.

High-dose intravenous metoclopramide versus combination high-dose metoclopramide and intravenous dexamethasone in preventing cisplatin-induced nausea and emesis: a single-blind crossover comparison of antiemetic efficacy.

1985 ◽  
Vol 3 (2) ◽  
pp. 245-251 ◽  
Author(s):  
S B Strum ◽  
J E McDermed ◽  
D F Liponi
Keyword(s):  
Patient Preference ◽  
Nausea And Vomiting ◽  
High Dose ◽  
Chemotherapy Response ◽  
Antiemetic Efficacy ◽  
Study Results ◽  
Nausea And Emesis ◽  
To Receive ◽  
Single Blind ◽  
Crossover Comparison

We tested the safety and antiemetic effectiveness of intravenous (IV) dexamethasone (DXM) as an adjunct to high-dose IV metoclopramide (MCP) to prevent nausea and vomiting induced by high-dose cisplatin chemotherapy. Response was determined by using objective and subjective criteria. Thirty patients were randomly assigned to receive MCP alone at a dose of 2 mg/kg IV for three doses or the same dose of MCP plus 20 mg of DXM IV for three doses. Twenty evaluable patients received a second course of cisplatin and were crossed over to the opposite arm. Study results did not show a statistically significant advantage of combination MCP plus DXM over MCP alone using strict objective criteria for antiemetic response. However, patients subjectively preferred MCP plus DXM over MCP alone by nearly a 6:1 ratio, regardless of the randomization sequence. Although the addition of DXM does not appear to objectively improve emetic protection with high-dose MCP, we recommend MCP plus DXM to prevent nausea and vomiting induced by high-dose cisplatin chemotherapy when the use of steroids is not contraindicated, in view of patient preference for the combination.

scholarly journals A Randomized Double-Blinded Comparison of Metoclopramide, Ondansetron and Cyclizine in Day-Case Laparoscopy

1996 ◽  
Vol 24 (5) ◽  
pp. 546-551 ◽  
Author(s):  
S. A. Watts
Keyword(s):  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Relative Efficacy ◽  
Day Case ◽  
Detectable Difference ◽  
Double Blinded ◽  
To Receive ◽  
Significant Nausea ◽  
Antiemetic Agents

This study determined the overall incidence of postoperative nausea and vomiting (PONV) in 38 patients undergoing laparoscopic gynaecological procedures who received a standardized propofol/isoflurane anaesthetic but no pre-operative antiemetic. A further 166 patients similarly anaesthetized were then randomly allocated to receive either metoclopramide 10 mg, ondansetron 4 mg, or cyclizine 50 mg as an intravenous antiemetic immediately pre-induction. Overall incidence of PONV was determined for all groups and the relative efficacy of the three antiemetic agents assessed. Fifty per cent of patients in the initial group (no antiemetic) reported significant nausea and/or vomiting up to 24 hours postoperatively. The incidence of PONV in the metoclopramide group was 24%, in the ondansetron group 20%, and in the cyclizine group 51%. There was no detectable difference in relative efficacy between ondansetron 4 mg and metoclopramide 10 mg. The incidence of PONV in the group who received cyclizine was similar to that found in the pilot group who received no PONV prophylaxis. Both metoclopramide and ondansetron may potentially decrease the incidence of PONV following gynaecologic laparoscopy by up to 50% when administered intravenously prior to a propofol/isoflurane anaesthetic.

Vinblastine fails to improve response of renal cancer to interferon alfa-n1: high response rate in patients with pulmonary metastases.

1991 ◽  
Vol 9 (5) ◽  
pp. 832-836 ◽  
Author(s):  
J A Neidhart ◽  
S A Anderson ◽  
J E Harris ◽  
J J Rinehart ◽  
J Laszlo ◽  
...  
Keyword(s):  
Response Rate ◽  
Complete Response ◽  
High Response Rate ◽  
Interferon Alfa ◽  
Induction Treatment ◽  
Small Subset ◽  
Research Triangle ◽  
Significant Difference ◽  
To Receive ◽  
Better Than

One hundred sixty-five patients were randomized to receive either interferon alfa-n1 (Wellferon; Burroughs Wellcome Co, Research Triangle Park, NC) alone or with vinblastine. An initial six-cycle induction treatment consisted of interferon given at daily doses of 3, 5, 20, 20, and 20 x 10(6) U/m2 every 2 weeks. Vinblastine at a dose of 10 mg/m2 (later decreased to 5 mg/m2) was given on day 1 of alternate cycles. Toxicities were generally well tolerated. The overall response rate was 10% with no significant difference between treatment arms. Survival was also not significantly different for the arms. A small subset of patients (16) with metastases only to the lungs had a high complete response (CR) and partial response (PR) rate of 44%. Responses were durable, and overall survival of this group was much better than that of the other patients.

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