Postoperative nausea and vomiting in patients undergoing total abdominal hysterectomy under spinal anaesthesia

2005 ◽  
Vol 22 (7) ◽  
pp. 504-509 ◽  
Author(s):  
E. Kontrimaviciute ◽  
A. Baublys ◽  
J. Ivaskevicius
Keyword(s):  
Spinal Anaesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Nausea And Vomiting

scholarly journals Postoperative Nausea and Vomiting in Patients Undergoing Total Abdominal Hysterectomy Under Subarachnoid Block: A Randomized Study of Dexamethasone Prophylaxis

2013 ◽  
Vol 10 (2) ◽  
pp. 41-45 ◽  
Author(s):  
S Khatiwada ◽  
B Bhattarai ◽  
BK Biswas ◽  
K Pokharel ◽  
R Acharya ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Postoperative Period ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Nausea And Vomiting ◽  
Controlled Study ◽  
Subarachnoid Block ◽  
Group D

Background Postoperative nausea and vomiting is a common distressing problem in patients undergoing gynaecological surgery under anaesthesia including central neuraxial blockade, which requires frequent medical interventions. Objectives We aimed to find out the antiemetic effect of prophylactic dexamethasone for prevention of postoperative nausea and vomiting in patients undergoing total abdominal hysterectomy under subarachnoid block. Influences of dexamethasone on patient satisfaction and postoperative analgesia were also observed as secondary objectives. Methods This was a prospective, randomized, double blind, placebo controlled study conducted in BPKIHS, a Tertiary care University based hospital from January 2009 to April 2009, for a period of four months. This study involved 80 American Society of Anaesthesiologist Physical Status I&II patients undergoing total abdominal hysterectomy under subarachnoid block. Patients were divided into two groups of 40 each to receive either 4 mg of dexamethasone (group D) or normal saline (group N) in volume of 2 ml intravenously 1 hourr prior to subarachnoid block. Surgery was allowed to start with block height of at least T8 dermatome. Intraoperative and postoperative nausea and vomiting was observed using nausea and vomiting scale every 4 hour for 24 hours. Results Seven (17.4%) patients in group D and 11 (27.5%) patients in group N had nausea and vomiting in the intraoperative period (P=0.284). Sixteen (40%) patients in group D experienced nausea and vomiting in the postoperative period as compared to 27 (67.5%) in group N (P =0.0136). Accordingly, the mean requirement of rescue antiemetic was less in group D compared to Group N (P=0.042). Further, only 15 (37.5%) patients in group D required postoperative supplemental analgesic as compared to 23 (57.5%) in group N (P=0.058). After 24 hrs of surgery, 26 (65%) patients expressed satisfaction in group D as compared to 16 (40.0%) in group N (P =0.025). Conclusions Use of dexamethasone prior to subarachnoid block in patients undergoing total abdominal hysterectomy significantly reduces the incidence of nausea and vomiting and the requirement of antiemetic in the postoperative period, with better patient satisfaction. Kathmandu University Medical Journal | Vol.10 | No. 2 | Issue 38 | Apr – June 2012 | Page 41-45 DOI: http://dx.doi.org/10.3126/kumj.v10i2.7342

scholarly journals Comparative Efficacy of Ondansetron Versus Granisetron to Prevent Perioperative Nausea and Vomiting in Patients undergoing Gynaecological Surgery under Spinal Anaesthesia

2017 ◽  
Vol 6 (1) ◽  
pp. 1371
Author(s):  
Robina Makker ◽  
Amit Bhardwaj ◽  
Arwinder Pal Singh ◽  
Asha Anand
Keyword(s):  
Spinal Anaesthesia ◽  
Postoperative Period ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Study Groups ◽  
Early Postoperative Period ◽  
Nausea And Vomiting ◽  
Gynaecological Surgery ◽  
Significant Difference ◽  
Late Postoperative Period

<p><strong>Background</strong>: Posotoprative nausea and vomiting remains a persistent and distressing problem inspite of many advances on perioperative care and anti-emetic drugs. A newer antiemetic drug Granisetron has not been studied in patients undergoing gynaecological surgery under spinal anaesthesia.</p><p><strong>Objective</strong>: A randomized double blind study was conducted to compare Ondansetron and Granisetron for prevention of postoperative nausea and vomiting in patients undergoing gynaecological surgery under spinal anaesthesia.</p><p><strong>Material and methods</strong>: 60 consecutive patients, age between 20-65 years, ASA grade I and II undergoing gynaeacologicla surgery under spinal anaesthesia were randomized into two goups of 30 each. One group received intravenous Ondansetron 4.0 mg and the second received intravenous Granisetron 2.0 mg 5 minutes before induction of anaesthesia. For the first 24 hours postoperatively all episodes of nausea and vomiting were recorded. A complete response to the drug was considered if there was no nausea or vomiting and no need for rescue anti-emetic. The observations were tabulated and analysed.</p><p><strong>Results</strong>: During early postoperative period (0-3 hrs) there was statistically no significant difference in the study groups. Statistically significant difference was found in the study groups in the late postoperative period (3-24 hrs).</p><p><strong>Conclusion</strong>: In the early postoperative period both Ondansetron and Granisetron are equally effective in preventing postoperative nausea and vomiting in patients undergoing gynaecological surgery under spinal anaesthesia. Granisetron is better than Ondansetron in the late postoperative period of upto 24 hrs.</p>

scholarly journals Risk of postoperative nausea and vomiting in hip and knee arthroplasty: a prospective cohort study after spinal anaesthesia including intrathecal morphine

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Antonio Moraitis ◽  
Magnus Hultin ◽  
Jakob Walldén
Keyword(s):  
Cohort Study ◽  
Spinal Anaesthesia ◽  
Postoperative Nausea ◽  
Intrathecal Morphine ◽  
Univariate Analysis ◽  
Postoperative Nausea And Vomiting ◽  
Female Gender ◽  
Nausea And Vomiting ◽  
Number Of Patients ◽  
Hip And Knee Arthroplasty

Abstract Background The overall risk of postoperative nausea and vomiting after general anaesthesia is approximately 30% even with prophylactic medications. Studies exploring the risk after regional anaesthesia including intrathecal morphine are limited but indicate that intrathecal morphine is highly emetogenic and is additive to the PONV risk associated with other forms of anaesthesia. The aim of this observational study was to investigate the risk of PONV after spinal blockade combined with intrathecal morphine and to explore associations with patient and perioperative factors, including given PONV-prophylaxis. We hypothesized that a large number of patients in a clinical setting receive less prophylaxis than the recommendations in guidelines (suboptimal prophylaxis), leading to a higher risk for PONV compared to those receiving adequate PONV prophylaxis. Methods The study was conducted as a prospective observational cohort study regarding PONV in patients undergoing hip/knee replacement under spinal anaesthesia including intrathecal morphine. Patients were included at a county hospital in Sweden during April–November 2013 (n = 59) and September 2014–June 2015 (n = 40). One hundred eight patients entered the study with 99 patients analysed in the final cohort. Patients were followed the first three postoperative days with a questionnaire regarding PONV and peri- and postoperative data was collected. PONV risk is presented as the proportion of patients (%) with PONV and was related to the level of perioperative PONV-prophylaxis (suboptimal/optimal). Univariate analysis was used to analyse factors associated with PONV. Results Forty-six patients (46%) experienced PONV during the 3-day study period whereof 36 patients (36%) until noon the first day after the procedure. 19/27 patients (70%) that received suboptimal PONV-prophylaxis experienced PONV compared to 27/72 (38%) that received optimal PONV-prophylaxis (p = 0.015). Further, female gender and/or a history of motion sickness were associated with an increased PONV-risk. Conclusions There was a high risk for PONV after spinal anaesthesia including morphine. PONV risk was associated with the level of prophylaxis and with known risk factors for PONV. Our findings suggest that a more liberal use of PONV prophylaxis might be motivated.

Substance P (Neurokinin-1) Antagonist Prevents Postoperative Vomiting after Abdominal Hysterectomy Procedures

2000 ◽  
Vol 93 (4) ◽  
pp. 931-937 ◽  
Author(s):  
Zsuzsanna Gesztesi ◽  
Phillip E. Scuderi ◽  
Paul F. White ◽  
William Wright ◽  
Ronald H. Wender ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Abdominal Hysterectomy ◽  
Nausea And Vomiting ◽  
Gynecologic Surgery ◽  
Postanesthesia Care Unit ◽  
Interaction Study ◽  
Dose Ranging ◽  
Neurokinin 1

Background The safety and antiemetic efficacy of CP-122,721, a novel neurokinin-1 antagonist, was evaluated when administered alone or in combination with ondansetron. Methods Using a randomized, double-blind, placebo-controlled study design, CP-122,721 was initially compared with placebo and subsequently to ondansetron alone and in combination for prophylaxis against postoperative nausea and vomiting in 243 women undergoing abdominal hysterectomy. In the dose-ranging studies (n = 86), patients received either CP-122,721 100 mg (vs. placebo) or 200 mg (vs. placebo) orally 60-90 min before induction of anesthesia. In the interaction study (n = 157), patients received CP-122,721 200 mg or placebo 60-90 min before induction of anesthesia, and ondansetron 4 mg or saline 2 ml intravenously 15-30 min before the end of surgery. Patients assessed their level of nausea and pain on arrival in the postanesthesia care unit and at 0.5-, 1-, 1.5-, 2-, 4-, 8-, 12-, and 24-h intervals postoperatively. Emetic episodes, need for rescue antiemetic-antinausea medication, postoperative complications, and patient satisfaction were recorded. Results In the initial dose-ranging study, only 10% of the patients experienced emesis within the first 8 h after surgery with CP-122,721 200 mg compared with 50% in the placebo group. CP-122,721 200 mg also decreased the need for rescue medication (25% vs. 48%). CP-122,721 100 mg was less effective than 200 mg in decreasing the incidence of repeated episodes of emesis. In the interaction study, 6% of the patients receiving CP-122,721 200 mg orally experienced emesis less than 2 h after surgery compared with 17% with ondansetron alone. With combined therapy, only 2% experienced emesis. In addition, the median times for 75% of patients to remain free from postoperative nausea and vomiting were 82, 75, and 362 min in the ondansetron, CP-122,721, and combination groups, respectively. Conclusions Oral CP-122,721 200 mg decreased emetic episodes compared with ondansetron (4 mg intravenously) during the first 24 h after gynecologic surgery; however, there was no difference in patient satisfaction.

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