scholarly journals The use of high-dose intrathecal diamorphine in laparoscopic bariatric surgery: a single-centre retrospective cohort study

2018 ◽  
Vol 13 (2) ◽  
pp. 106-111 ◽  
Author(s):  
Thomas G Wojcikiewicz ◽  
John Jeans ◽  
Anil Karmali ◽  
Jackline Nkhoma ◽  
Jonathan Cousins ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Nausea And Vomiting ◽  
Morphine Consumption ◽  
Randomised Control Trial ◽  
High Dose ◽  
Laparoscopic Bariatric Surgery ◽  
Pain Scores ◽  
Anaesthetic Care ◽  
Spinal Anaesthetic ◽  
Post Operative Nausea

Introduction: The use of intrathecal diamorphine is not commonplace in laparoscopic bariatric surgery. At our institution, a major UK bariatric centre, high-dose intrathecal diamorphine is routinely utilised. Methods: Data were analysed retrospectively. Fifty-three patients who had a spinal anaesthetic were matched against age, sex, body mass index and surgical procedure type to generate controls. Pain scores were recorded in the post-anaesthetic care unit on arrival, after 1 hour and on discharge to the ward. Post-operative nausea and vomiting; post-operative hypertension; pruritus; 24-hour morphine consumption and length of stay were measured. Results: Pain scores were better in the spinal anaesthetic group in all measured categories (p = 0.033, p < 0.01, p < 0.01); post-operative nausea and vomiting was less common in the spinal anaesthetic group (p < 0.01); post-operative hypertension was less common in the spinal anaesthetic group (p = 0.25); pruritus was more common in the spinal anaesthetic group (p < 0.01); morphine consumption was less common in the spinal anaesthetic group (p = 0.037). Length of hospital stay was reduced by 12.4 hours (p = 0.025). Conclusion: We propose that this is a practical and safe technique to adopt. A randomised-control trial will need to be conducted in order to find the most efficacious volume of local anaesthetic and dose of diamorphine

scholarly journals Effects of Modification of Pain Protocol on Incidence of Post Operative Nausea and Vomiting

2016 ◽  
Vol 10 (1) ◽  
pp. 505-511 ◽  
Author(s):  
Ran Schwarzkopf ◽  
Nimrod Snir ◽  
Zachary T. Sharfman ◽  
Joseph B. Rinehart ◽  
Michael-David Calderon ◽  
...  
Keyword(s):  
Patient Care ◽  
Postoperative Nausea ◽  
Total Joint Replacement ◽  
Postoperative Nausea And Vomiting ◽  
Improve Patient Care ◽  
Immediate Release ◽  
Nausea And Vomiting ◽  
Pain Scores ◽  
Management Protocol ◽  
Post Operative Nausea

Background: A Perioperative Surgical Home (PSH) care model applies a standardized multidisciplinary approach to patient care using evidence-based medicine to modify and improve protocols. Analysis of patient outcome measures, such as postoperative nausea and vomiting (PONV), allows for refinement of existing protocols to improve patient care. We aim to compare the incidence of PONV in patients who underwent primary total joint arthroplasty before and after modification of our PSH pain protocol. Methods: All total joint replacement PSH (TJR-PSH) patients who underwent primary THA (n=149) or TKA (n=212) in the study period were included. The modified protocol added a single dose of intravenous (IV) ketorolac given in the operating room and oxycodone immediate release orally instead of IV Hydromorphone in the Post Anesthesia Care Unit (PACU). The outcomes were (1) incidence of PONV and (2) average pain score in the PACU. We also examined the effect of primary anesthetic (spinal vs. GA) on these outcomes. The groups were compared using chi-square tests of proportions. Results: The incidence of post-operative nausea in the PACU decreased significantly with the modified protocol (27.4% vs. 38.1%, p=0.0442). There was no difference in PONV based on choice of anesthetic or procedure. Average PACU pain scores did not differ significantly between the two protocols. Conclusion: Simple modifications to TJR-PSH multimodal pain management protocol, with decrease in IV narcotic use, resulted in a lower incidence of postoperative nausea, without compromising average PACU pain scores. This report demonstrates the need for continuous monitoring of PSH pathways and implementation of revisions as needed.

scholarly journals Comparison of the effects of preoperative melatonin or vitamin C administration on postoperative analgesia

2019 ◽  
Author(s):  
Demet Laflı Tunay ◽  
Murat Türkeün Ilgınel ◽  
Hakkı Ünlügenç ◽  
Merthan Tunay ◽  
Feride Karacaer ◽  
...  
Keyword(s):  
Vitamin C ◽  
Postoperative Analgesia ◽  
Nausea And Vomiting ◽  
Morphine Consumption ◽  
Patient Controlled Analgesia ◽  
Analgesic Requirement ◽  
Analgesic Effects ◽  
Placebo Tablet ◽  
Pain Scores ◽  
The Mean

The analgesic benefit of melatonin and vitamin C as primary or adjuvant agents has been reported in various studies; however, their analgesic effects in the treatment of postoperative pain remain unclear. Thus, we aimed to evaluate the effect of single preoperative dose of oral melatonin or vitamin C administration on postoperative analgesia. In this study, we recruited 165 adult patients undergoing elective major abdominal surgery under general anesthesia. Patients were randomly divided into three equal (n = 55) groups. One hour before surgery, patients received orally melatonin (6 mg) in group M, vitamin C (2 g) in group C, or a placebo tablet in group P. Pain, sedation, patient satisfaction, total morphine consumption from a patient-controlled analgesia device, supplemental analgesic requirement, and the incidence of nausea and vomiting were recorded throughout 24 h after surgery. The mean pain score and total morphine consumption were found significantly lower in both M and C groups compared with group P (p < 0.001). There were no significant differences between group M and C with respect to pain scores (p = 0.117) and total morphine consumption (p = 0.090). Patients requested less supplemental analgesic and experienced less nausea and vomiting in groups M and C compared with group P. In conclusion, preoperative oral administration of 6 mg melatonin or 2 g vitamin C led to a reduction in pain scores, total morphine consumption, supplemental analgesic requirement, and the incidence of nausea and vomiting compared with placebo.

P93: Preventing post-operative nausea and vomiting following bariatric surgery

2008 ◽  
Vol 4 (3) ◽  
pp. 347
Author(s):  
Jeffrey F. Barletta ◽  
Douglas Hoover ◽  
Ronald B. Mengel ◽  
Todd Emery ◽  
Randal Baker
Keyword(s):  
Bariatric Surgery ◽  
Nausea And Vomiting ◽  
Post Operative Nausea

Weighting (also) the risk of post-operative nausea and vomiting in bariatric surgery: time for opioid free anesthesia

2017 ◽  
Vol 61 (7) ◽  
pp. 856-857 ◽  
Author(s):  
M. Sorbello ◽  
G. S. Pulvirenti ◽  
E. Panascia ◽  
I. Di Giacinto
Keyword(s):  
Bariatric Surgery ◽  
Nausea And Vomiting ◽  
Post Operative Nausea

Pain, nausea and vomiting after laparoscopic bariatric surgery

2014 ◽  
Vol 31 ◽  
pp. 15
Author(s):  
I. Valdoleiros ◽  
A. C. Midões ◽  
A. C. Sá ◽  
P. Reis ◽  
F. Abelha ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Nausea And Vomiting ◽  
Laparoscopic Bariatric Surgery

scholarly journals Re-Print-A Comparison between Conventional Throat Packs and Pharyngeal Placement of Tampons in Rhinology Surgeries.

2020 ◽  
Vol 2 (2) ◽  
pp. 01-07
Author(s):  
Hasan Alansari
Keyword(s):  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
The Other ◽  
Nausea And Vomiting ◽  
Visual Analog Scales ◽  
Pain Scores ◽  
Impact Scale ◽  
The Mean ◽  
Spss Software ◽  
Post Operative Nausea

Objective: the aim is to evaluate the incidence of postoperative throat pain, nausea and vomiting in patients that have been packed with either conventional gauze or pharyngeal tampons. Methods: We included adult patients who were booked for a rhinology surgery that needed throat packs. They were allocated into two groups, pharyngeal tampons, and conventional ribbon gauze. They were then assessed using visual analog scales and Post-operative nausea and vomiting impact scale respectively in the 1st, 4th, and 24th hour. Data was analyzed using SPSS software version 25. Results: There is evidence to suggest that using pharyngeal tampons reduces the mean VAS score at 4 hours compared to using Gauze. [t87=3.294, p=0.001), the is no statistical evidence that show a difference in the other Visual analogue scores or post-operative nausea and vomiting scores. Conclusion: The study shows that the use of pharyngeal tampons is associated with decreased pain scores, however, it also shows that there no difference in postoperative nausea and vomiting.

scholarly journals Post operative nausea and vomiting, its causes, and the way of its prevention and treatment

2021 ◽  
Vol 6 (1) ◽  
pp. 1405-1415
Author(s):  
Surendra Maharjan ◽  
Zhang Bing
Keyword(s):  
Risk Factor ◽  
General Anaesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Modal Approach ◽  
Anaesthetic Care ◽  
Prevention And Treatment ◽  
Post Operative Nausea ◽  
Antiemetic Medication

Postoperative nausea and vomiting is still occurring in one third of the patient undergoing surgery under general anaesthesia even after following the guidelines and using multi modal approach for its prevention. Lots of studies have been done for its prevention but very few studies are done for its treatment in Post anaesthetic care unit after the failure of prophylaxis. The purpose of this article is to know about the risk factor, incidence of nausea and vomiting after surgery, its mechanism, available medication (pharmacological and nonpharmacological), reducing risk factor, and mainly to know about the method of using the antiemetic medication in PACU after the failure of the prophylactic medication.

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