A single intravenous dose of clonidine (4 μg/kg) given before induction reduces postoperative nausea and vomiting in patients after myomectomy under general anesthesia

2013 ◽  
Vol 30 ◽  
pp. 148-148 ◽  
Author(s):  
A. Bouslama ◽  
H. Echehoumi ◽  
S. Smairi ◽  
Jazia K. Ben
Author(s):  
Sunil Arjan ◽  
Naila Zahoor ◽  
Kenza Nadeem ◽  
Farah Liaquat ◽  
Tariq Hussain Mughal ◽  
...  

Objective:To evaluate the efficacy of Metoclopramide versus Dexamethasone for prevention of postoperative nausea and vomiting during general anesthesia. Study Design:This is a Randomized control trial (RCT) study. Setting: Study carried out at Department of Anaesthesiology, Surgical Intensive Care Unit and Pain Management, Clinic, Dow University of Health Sciences and  Dr. Ruth Pfau  Hospital Karachi, from December 2018 to June 2019. Materials and Methods:110 patients undergoing elective surgeries, who fulfilled the inclusion criteria and gave informed consent were included in the study. They were randomly assigned to either group M or group D, with 55 patients in each group. All patients were then administered either intravenous dexamethasone (8mg) in group D or intravenous metoclopramide (10mg) in group M at the time of induction of anesthesia. The main outcome measure was postoperative nausea and vomiting, at the end of 6th hour postoperatively. The SPSS version 21 was applied to the data. Results: Majority of the patients 66 (60%) were of age 35 years or less. Mean age of the patients was 35.09±11.55 years. There were more females than males, with male to female ratio being 1:1.03. Overall, in patients receiving metoclopramide, 12(21.8%)  had postoperative nausea and vomiting, while in patients who received dexamethasone, only 4 (7.3%) patients had post-operative nausea and vomiting. When comparing two groups, there was statistically significant (p= 0.02) reduced postoperative nausea/vomiting among those patients who had received intravenous dexamethasone. Conclusion: Intravenous dexamethasone is more effective than Metoclopramide in preventing postoperative nausea and vomiting in patients during general anesthesia.


2018 ◽  
Vol 6 (2) ◽  
pp. 25
Author(s):  
Reihan Shenasi ◽  
Hamzeh Hoseinzadeh ◽  
Hasan Mohammadpor-Anvari ◽  
Davod Aghamohammadi ◽  
Reza Sari-Motlagh

Bispectral index parameter is used to guide the titration of general anesthesia. This monitoring improves recovery times and hospital discharges, as well as minimizes adverse events. The objective of this study is the comparison of anesthesia depth monitoring by conventional and bispectral index on nausea and vomiting after urological surgery. 180 participants who were scheduled for abdominal urological surgery were studied. Patients before induction of anesthesia were randomize into two groups with and without bispectral index monitoring. Incidence and severity of nausea and vomiting were recorded every 30 minutes for 2 hours and every 6 hours to 24 hours after surgery. The incidence of postoperative nausea and vomiting in Bispectral index group is 14.4% and 8.9% and in control group 28.9% and 23.3%, respectively. The risk of nausea and vomiting after surgery was reduced by 14.5% and 14.4%, respectively in patients monitored with bispectral index.INTRODUCTIONNausea is the conscious perception of medulla stimulation that is associated with vomiting center and create vomiting response (1). General anesthesia with the use of inhalants can cause nausea and vomiting after surgery (Postoperative nausea and vomiting, PONV). The incidence of PONV is reported about 20-30 percent (2). It seems that multiple-factor can cause PONV and few items such as anesthetic drugs, kind of surgery and personal risk factors is effective on PONV. These factors make into two categories that includes factors out of control by anesthesiologists and factors can control by anesthesiologists.1. Factors out of control by anesthesiologists: some of these factors are age, gender, past history of PONV and motion sickness, smoking, kind of surgery, operating time and anesthesia time, anxiety of patients and parents. 2. Factors controlled by anesthesiologists: these factors are associated of anesthesia settings, including premedications, kind of anesthesia, anesthesia drugs during surPublishedby Australian


2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Xian-Xue Wang ◽  
Quan Zhou ◽  
Dao-Bo Pan ◽  
Hui-Wei Deng ◽  
Ai-Guo Zhou ◽  
...  

Background. Laparoscopic cholecystectomy is usually carried out under general anesthesia. There were a few studies which have found spinal anesthesia as a safe alternative. We aimed to evaluate the postoperative events between spinal anesthesia and general anesthesia in patients undergoing laparoscopic cholecystectomy.Methods. We searched PubMed, Embase, and Cochrane Library (from inception to January 2016) for eligible studies. The primary outcome was the visual analogue scale score. Secondary outcomes included postoperative nausea and vomiting and urine retention 24 hours postoperatively. We calculated pooled risk ratios and 95% confidence interval using random- or fixed-effects models.Results. Eight trials involving 723 patients were listed. Meta-analysis showed that patients in spinal anesthesia groups have lower visual analogue scale score 24 hours postoperatively. There were significant decreases in the occurrence of postoperative nausea and vomiting in spinal anesthesia group when compared with general anesthesia group (odds ratios: 0.38, 95% confidence interval: 0.19–0.76;P=0.006) with heterogeneity accepted (I2=13%;P=0.33), while urine retention rate was increased in patients with spinal anesthesia (odds ratios: 4.95, 95% confidence interval: 1.24–19.71;P=0.02) without any heterogeneity (I2=0%;P=0.98).Conclusions. Spinal anesthesia may be associated with less postoperative pain and postoperative nausea and vomiting compared with general anesthesia.


1998 ◽  
Vol 89 (4) ◽  
pp. 838-843 ◽  
Author(s):  
Dajun Song ◽  
Charles W. Whitten ◽  
Paul F. White ◽  
Song Y. Yu ◽  
Eduardo Zarate

Background Controversy exists regarding the effectiveness of propofol to prevent postoperative nausea and vomiting. This prospective, randomized, single-blinded study was designed to evaluate the antiemetic effectiveness of 0.5 mg/kg propofol when administered intravenously after sevoflurane- compared with desflurane-based anesthesia. Methods Two hundred fifty female outpatients undergoing laparoscopic cholecystectomy were assigned randomly to one of four treatment groups. All patients were induced with intravenous doses of 2 mg midazolam, 2 microg/kg fentanyl, and 2 mg/kg propofol and maintained with either 1-4% sevoflurane (groups 1 and 2) or 2-8% desflurane (groups 3 and 4) in combination with 65% nitrous oxide in oxygen. At skin closure, patients in groups 1 and 3 were administered 5 ml intravenous saline, and patients in groups 2 and 4 were administered 0.5 mg/kg propofol intravenously. Recovery times were recorded from discontinuation of anesthesia to awakening, orientation, and readiness to be released home. Postoperative nausea and vomiting and requests for antiemetic rescue medication were evaluated during the first 24 h after surgery. Results Propofol, in an intravenous dose of 0.5 mg/kg, administered at the end of a sevoflurane-nitrous oxide or desflurane-nitrous oxide anesthetic prolonged the times to awakening and orientation by 40-80% and 25-30%, respectively. In group 2 (compared with groups 1, 3, and 4), the incidences of emesis (22% compared with 47%, 53%, and 47%) and requests for antiemetic rescue medication (19% compared with 42%, 50%, and 47%) within the first 6 h after surgery were significantly lower, and the time to home-readiness was significantly shorter in duration (216 +/- 50 min vs. 249 +/- 49 min, 260 +/- 88 min, and 254 +/- 72 min, respectively). Conclusions A subhypnotic intravenous dose of propofol (0.5 mg/kg) administered at the end of outpatient laparoscopic cholecystectomy procedures was more effective in preventing postoperative nausea and vomiting after a sevoflurane-based (compared with a desflurane-based) anesthetic.


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