scholarly journals A Single Perioperative Injection of Dexamethasone Decreases Nausea, Vomiting, and Pain after Laparoscopic Donor Nephrectomy

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Shigeyoshi Yamanaga ◽  
Andrew Mark Posselt ◽  
Chris Earl Freise ◽  
Takaaki Kobayashi ◽  
Mehdi Tavakol ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Donor Nephrectomy ◽  
Nausea And Vomiting ◽  
Complication Rates ◽  
Opioid Use ◽  
Laparoscopic Donor Nephrectomy ◽  
Before And After

Background. A single dose of perioperative dexamethasone (8–10 mg) reportedly decreases postoperative nausea, vomiting, and pain but has not been widely used in laparoscopic donor nephrectomy (LDN). Methods. We performed a retrospective cohort study of living donors who underwent LDN between 2013 and 2015. Donors who received a lower dose (4–6 mg)  (n=70) or a higher dose (8–14 mg) of dexamethasone (n=100) were compared with 111 donors who did not receive dexamethasone (control). Outcomes and incidence of postoperative nausea, vomiting, and pain within 24 h after LDN were compared before and after propensity-score matching. Results. The higher dose of dexamethasone reduced postoperative nausea and vomiting incidences by 28% (P=0.010) compared to control, but the lower dose did not. Total opioid use was 29% lower in donors who received the higher dose than in control (P=0.004). The higher dose was identified as an independent factor for preventing postoperative nausea and vomiting. Postoperative complication rates and hospital stays did not differ between the groups. After propensity-score matching, the results were the same as for the unmatched analysis. Conclusion. A single perioperative injection of 8–14 mg dexamethasone decreases antiemetic and narcotic requirements in the first 24 h, with no increase in surgical complications.

scholarly journals Comparison of the Effects of Sugammadex, Neostigmine, and Pyridostigmine on Postoperative Nausea and Vomiting: A Propensity Matched Study of Five Hospitals

2020 ◽  
Vol 9 (11) ◽  
pp. 3477
Author(s):  
Jong Ho Kim ◽  
Man-Sup Lim ◽  
Jun Woo Choi ◽  
Haewon Kim ◽  
Young-Suk Kwon ◽  
...  
Keyword(s):  
Propensity Score ◽  
Confidence Interval ◽  
General Anesthesia ◽  
Propensity Score Matching ◽  
Postoperative Nausea ◽  
Odds Ratio ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Patient Groups ◽  
Matched Study

Thus far, few studies have compared the effects of sugammadex and cholinesterase inhibitors on postoperative nausea and vomiting (PONV), and the results have been controversial. Here, we compared the effects of sugammadex, neostigmine, and pyridostigmine on PONV by means of a five hospital analysis with propensity score matching. We analyzed adults aged ≥ 18 years who underwent general anesthesia between January 2014 and December 2019. Following propensity score matching, 7793 patients were included in each of the neostigmine and sugammadex matched patient groups (absolute standardized difference (ASD), 0.01–0.07), and 10,197 patients were included in each of the pyridostigmine and sugammadex matched patient groups (ASD, 0.01–0.02), while 19,377 patients were included in each of the pyridostigmine and neostigmine matched patient groups. (ASD, 0.01–0.19). The odds of PONV were low in the sugammadex group (odds ratio, 0.65; 95% confidence interval, 0.59–0.72; p < 0.0001) and pyridostigmine group (odds ratio, 0.22; 95% confidence interval, 0.20–0.24; p < 0.0001) compared to the neostigmine group, while there was no difference between sugammadex and pyridostigmine (odds ratio, 0.95; 95% confidence interval, 0.86–1.04; p = 0.281). Therefore, sugammadex and pyridostigmine may lower the incidence of PONV compared to neostigmine in patients undergoing general anesthesia.

scholarly journals Droperidol Reduces Postoperative Nausea and Vomiting and Supports the Continuation of Intravenous Patient-Controlled Analgesia with Fentanyl

2020 ◽  
Vol 23 ◽  
pp. 220-230
Author(s):  
Ikkou Hirata ◽  
Masahiro Iwamoto ◽  
Hiroki` Matsui ◽  
Hiromi Yoshinuma ◽  
Ryohkan Funakoshi
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Postoperative Nausea ◽  
Pain Treatment ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Patient Controlled Analgesia ◽  
Secondary Endpoints ◽  
The Impact

PURPOSE: To examine the impact of adding droperidol to fentanyl-based intravenous patient-controlled analgesia (IVPCA) on the discontinuation of IVPCA use due to postoperative nausea and vomiting (PONV). METHODS: Patients who underwent surgeries other than abdominal surgeries and used IVPCA between April 2014 and March 2018 were selected. Patients using IVPCA with fentanyl alone were compared to patients using droperidol added to IVPCA. Patients were allocated to one of two groups depending on the drug used for IVPCA: 1) control group, fentanyl alone; 2) droperidol group, droperidol with fentanyl. The primary endpoint was the discontinuation of IVPCA due to PONV. Secondary endpoints included PONV within 48 hours after surgery, the number of antiemetics used, pain score, and adverse effects. Propensity score matching was used to control the differences in clinical features among patients. RESULTS: Among the 793 patients initially enrolled in this study, 145 were excluded via propensity score matching; 364 of the remaining patients received IVPCA supplemented with droperidol. Propensity score matching showed that discontinuation of IVPCA due to PONV was significantly decreased in the droperidol group compared to the control group (P = 0.01). Further, compared with the control group, the droperidol group had reduced nausea up to 24 hours after surgery (P < 0.01), and the number of vomiting episodes and use of antiemetics decreased within 12 hours after surgery (P < 0.01). CONCLUSIONS: The addition of droperidol to IVPCA is associated with a decrease in PONV, as well as the improved continuation of pain treatment with fentanyl-based IVPCA, similar to IVPCA with morphine. However, it is necessary to monitor the side effects of this treatment.

scholarly journals Effect of Body Mass Index on Postoperative Nausea and Vomiting: Propensity Analysis

2020 ◽  
Vol 9 (6) ◽  
pp. 1612 ◽  
Author(s):  
Jong Ho Kim ◽  
Mingi Hong ◽  
Young Joon Kim ◽  
Ho Seok Lee ◽  
Young Suk Kwon ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Body Mass ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Obese Patients ◽  
Underweight Patients ◽  
The Impact

The impact of body mass index (BMI) on postoperative nausea and vomiting (PONV) is controversial, and few studies have focused on their relationship. We investigated the effects of BMI on PONV, taking into account other PONV risk factors. We analyzed adults over the age of 18 years who received general anesthesia between 2015 and 2019, using propensity score matching. Before propensity score matching, odds ratios (ORs) for PONV were lower for overweight (OR, 0.91; 95% confidence interval (CI), 0.87–0.96; p < 0.0001) or obese patients (OR, 0.77; 95% CI, 0.71–0.84; p < 0.0001) than for normal-BMI patients. After matching, the ORs for PONV of overweight (OR, 0.89; 95% CI, 0.80–0.98; p = 0.016) and obese patients (OR, 0.71; 95% CI, 0.63–0.79; p < 0.0001) were low. However, the ORs of underweight patients did not differ from those of normal-BMI patients, irrespective of matching. Therefore, the incidence of PONV may be lower among adults with a higher-than-normal BMI.

Postoperative Nausea and Vomiting Are Strongly Influenced by Postoperative Opioid Use in a Dose-Related Manner

2005 ◽  
Vol 101 (5) ◽  
pp. 1343-1348 ◽  
Author(s):  
Gregory W. Roberts ◽  
Tenna B. Bekker ◽  
Helle H. Carlsen ◽  
Christine H. Moffatt ◽  
Peter J. Slattery ◽  
...  
Keyword(s):  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Opioid Use

scholarly journals Simplified algorithm for the prevention of postoperative nausea and vomiting: a before-and-after study

2018 ◽  
Vol 120 (1) ◽  
pp. 156-163 ◽  
Author(s):  
G. Dewinter ◽  
W. Staelens ◽  
E. Veef ◽  
A. Teunkens ◽  
M. Van de Velde ◽  
...  
Keyword(s):  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Before And After ◽  
Simplified Algorithm ◽  
Before And After Study

Reduction of Postoperative Nausea and Vomiting through Patient Risk Stratification

2007 ◽  
Vol 24 (3) ◽  
pp. 135-138
Author(s):  
Gregory W. Pippin ◽  
John Liukkonen ◽  
Michael Garret ◽  
William Silver
Keyword(s):  
Risk Stratification ◽  
Plastic Surgery ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Control Group ◽  
P Value ◽  
Patient Risk ◽  
True Incidence ◽  
Before And After

Objective: To develop a patient risk stratification algorithm that will reduce the incidence of postoperative nausea and vomiting (PONV) in an ambulatory plastic surgery practice by increasing the use of prophylactic medications as the risk of PONV increases. Design: Retrospective review of an ambulatory plastic surgery practice before and after a PONV patient risk stratification algorithm was introduced. A patient risk stratification algorithm was developed based on known causes of PONV. Incidence of patients experiencing PONV before and after the introduction of the patient risk stratification algorithm was compared. Results of the study were analyzed with logistic regression. Results: The rate of PONV was 17.7% before the patient risk stratification algorithm was instituted and 4.47% after. This difference is significant (one-sided P value against no difference in true incidence of PONV = .003). A history of PONV and longer lengths of anesthesia were associated with higher likelihoods of PONV (P = .02 and .0056, respectively), and application of our patient algorithm (ie, membership in the study group as opposed to the control group) was associated with a lower likelihood of PONV (P < .001). Conclusion: Patient risk stratification and a multimodality approach to PONV prophylaxis effectively reduce the rate of PONV in an ambulatory plastic surgery practice.

scholarly journals Comparison of Ramosetron with Palonosetron for Prevention of Postoperative Nausea and Vomiting in Patients Receiving Opioid-Based Intravenous Patient-Controlled Analgesia after Gynecological Laparoscopy

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Eun Jin Ahn ◽  
Geun Joo Choi ◽  
Hyun Kang ◽  
Chong Wha Baek ◽  
Yong Hun Jung ◽  
...  
Keyword(s):  
Propensity Score ◽  
Electronic Medical Records ◽  
Postoperative Nausea ◽  
Medical Records ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Confounding Factors ◽  
Patient Controlled Analgesia ◽  
Complete Responder ◽  
Gynecological Laparoscopy

We aimed to compare the effects of ramosetron and palonosetron in the prevention of postoperative nausea and vomiting (PONV) in patients that received opioid-based intravenous patient-controlled analgesia (IV-PCA) after gynecological laparoscopy. We reviewed the electronic medical records of 755 adults. Patients were classified into two groups, ramosetron (group R,n=589) versus palonosetron (group P,n=166). Based on their confounding factors, 152 subjects in each group were selected after the implementation of propensity score matching. The overall incidence of PONV at postoperative day (POD) 0 was lower in group R compared to group P (26.9% versus 36.8%;P=0.043). The severity of nausea was lower in group R than in group P on postoperative day (POD) 0 (P=0.012). Also, the complete responder proportion of patients was significantly higher in group R compared to that in group P on POD 0 (P=0.043). In conclusion, ramosetron showed a greater efficacy in the prevention of postoperative nausea at POD 0 compared to palonosetron in patients after gynecological laparoscopy.

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