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 SUN-042 Low Dose Cyproterone Acetate for the Treatment of Transgender Women - a Retrospective Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Naomi Even-Zohar ◽  
Yael Sofer ◽  
Iris Yaish ◽  
Merav Serebro ◽  
Karen Tordjman ◽  
...  
Keyword(s):  
Cyproterone Acetate ◽  
Dose Group ◽  
Low Dose ◽  
Dose Range ◽  
Hormonal Treatment ◽  
Transgender Women ◽  
High Dose ◽  
Historical Cohort ◽  
Treatment Groups ◽  
First Time

Abstract Introduction : Transgender women with intact gonads receive lifelong hormonal treatment in order to suppress physiologic androgen production. Cyproterone acetate (CA) is the most comon antiandrogenic drug prescribed for this indication in Europe, with a dose range between 25-100 mg/day. Aim: To assess the effectiveness and safety of low dose (<20 mg/day), compared with high dose (>50 mg/day) CA treatment. Methods: Historical cohort study of transgender women treated in our department between January 2000 and October 2018. Results: There were 42 transgender women in the low dose group (LDG) and 32 in the high dose group (HDG). Age (27.9 ± 1.6 vs.28.9 ± 1.7 years) and follow up time (16.2 ± 2.2 vs. 20.1 ± 2.1 months) were similar in the LDG and HDG, respectively. At the last available visit, testosterone levels were effectively and similarly suppressed in both treatment groups (0.6 ± 0.1 vs 0.8 ± 0.3 nmol/l; p=0.37, for LDG and HDG respectively). Prolactin (659 ± 64 vs 486 ± 42 mIU/ml, p=0.02), LDL cholesterol (96.1 ± 5 vs 78.5 ± 4 mg/dl, p= 0.02) and triglycerides (93.3 ± 9 vs 69 ± 5 mg/dl; p=0.02) were higher in the HDG compared with LDG respectively. Side effects were common in the HDG (four cases of increased liver enzymes, one case of pulmonary embolism and one case of sudden death). Conclusion: We show for the first time that anti-androgenic treatment of transgender women with low dose CA is as effective as high dose treatment, but safer. We suggest incorporation of this observation in future guidelines.

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.

One-year, low-dose neuroleptic study of in-patients with chronic schizophrenia characterised by persistent negative symptoms

1997 ◽  
Vol 171 (6) ◽  
pp. 564-568 ◽  
Author(s):  
Jeremy C. Speller ◽  
Thomas R. E. Barnes ◽  
David A. Curson ◽  
Christos Pantelis ◽  
J. L. Alberts
Keyword(s):  
Negative Symptoms ◽  
Low Dose ◽  
Chronic Schizophrenia ◽  
Anticholinergic Medication ◽  
Treatment Groups ◽  
Substituted Benzamide ◽  
One Year ◽  
To Receive ◽  
Persistent Negative Symptoms

BackgroundAmisulpride is a potent substituted benzamide antipsychotic drug claimed to improve the negative symptoms of schizophrenia, particularly at low dosage.MethodSixty long-term in-patients with schizophrenia and selected for predominant negative symptoms were randomised to receive either haloperidol or amisulpride. Over a year there was systematic dose reduction, as symptoms allowed.ResultsThere were no significant differences between the treatment groups in the proportion receiving low-dose treatment, the control of positive symptoms, or ratings of social behaviour, side-effects or tardive dyskinesia. For negative symptoms, there were consistent but non-significant trends in favour of amisulpride. The amisulpride patients required significantly less anticholinergic medication.ConclusionsIn chronically-hospitalised in-patients with schizophrenia characterised by persistent negative symptoms, amisulpride was a well-tolerated maintenance antipsychotic medication. The drug had only a limited effect in reducing negative symptoms, which were relatively stable, enduring phenomena in this sample, despite dosage reduction.

scholarly journals Low-dose dexamethasone effectively prevents postoperative nausea and vomiting after ambulatory laparoscopic surgery

2001 ◽  
Vol 48 (10) ◽  
pp. 973-977 ◽  
Author(s):  
Jeng-Chai Huang ◽  
Ja-Ping Shieh ◽  
Chao-Shun Tang ◽  
Jann-Inn Tzeng ◽  
Koung-Shing Chu ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Postoperative Nausea ◽  
Low Dose ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting
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