scholarly journals The prolonged sub-tenon block for long vitreoretinal surgery

2019 ◽  
Vol 11 (3) ◽  
pp. 13-22
Author(s):  
Nadezhda H. Marova ◽  
Yaroslav I. Vasilyev ◽  
Galina N. Vasilyeva ◽  
Polina A. Grib ◽  
Zemfira A. Dautova ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Postoperative Nausea ◽  
Vitreoretinal Surgery ◽  
Postoperative Nausea And Vomiting ◽  
Pain Syndrome ◽  
Muscle Relaxants ◽  
Laryngeal Mask ◽  
Nausea And Vomiting ◽  
Average Dose ◽  
Block Group

The purpose of this study was to compare efficiency and safety of the prolonged Sub-Tenon block in comparison with IV 100 mg tramadol for long vitreoretinal surgery ander general anesthesia. 74 patients were undergoing microinvasive vitrectomy. For the prolonged Sub-Tenon block 1% solution of lidocaine at the speed of 2 ml/hour was used. The value of block of oculovisceral reflexes, HR and MAP, the need for muscle relaxants, time of awakening and time of removal of a laryngeal mask, postoperative pain and analgesia requirements, and postoperative nausea and vomiting were recorded. In prolonged Sub-Tenon block group there was more effective blocking of oculocardiac and oculovasomotor reflexes, a smaller average dose of muscle relaxants, shorter awakening time and removal of a laryngeal mask, and also lower pain syndrome in the first 24 hours after surgery. Postoperative nausea and vomiting also was in Sub-Tenon block group considerably less frequent than in tramadol group. Use of the prolonged Sub-Tenon block with the general anesthesia is an effective and safe technique for vitreoretinal surgery.

scholarly journals Multimodal Low-opioid Anesthesia as an Effective Way to Prevent Postoperative Nausea and Vomiting. Pathophysiological Aspects of this Complication

2021 ◽  
Vol 6 (1) ◽  
pp. 101-106
Author(s):  
Т. Ovsiienko ◽  
◽  
M. Bondar ◽  
O. Loskutov ◽  
◽  
...  
Keyword(s):  
General Anesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Average Dose ◽  
Kidney Surgery ◽  
Group 2 ◽  
Total Average ◽  
Group 1

Postoperative nausea and vomiting are common adverse effects of anaesthesia and surgery. Up to 80% of patients may be affected. These outcomes are a major cause of patient dissatisfaction. In addition, postoperative nausea and vomiting can independently cause the occurrence of rather serious complications of the postoperative period, such as aspiration of gastric contents into the airways, hemodynamic disorders in patients with a compromised cardiovascular system, failure of surgical sutures, bleeding, dehydration and electrolyte imbalance which ultimately can lead to disability of patients, prolongation of their hospitalization and higher treatment costs. Material and methods. The paper presents the results of our own research on the use of multimodal low-opioid general anesthesia as one of the methods for the prevention of postoperative nausea and vomiting during anesthetic provision of laparoscopic kidney surgery. The study involved 38 patients who underwent laparoscopic kidney surgery. Results and discussion. To compare the incidence of postoperative nausea and vomiting, patients were randomly divided into two groups. Group 1 used multimodal general anesthesia with standard opioid doses, while group 2 used multimodal low-opioid general anesthesia. The total average dose of fentanyl that was used during the entire time of anesthesia in the control group was 373.3 ± 50.8 μg (4.34 μg / kg / h). The total average dose of fentanyl that was used during the entire time of anesthesia in the study group was 217.39 ± 49.1 μg (1.76 μg / kg / h). In group 1, vomiting occurred in 4 patients out of 15 in the postoperative period, in group 2 there were 4 patients with vomitting, but out of 23 operated patients. The standardized rate of postoperative nausea and vomiting in the control group was 26.6%, in the main group it was 17.3%. Conclusion. As a result of comparing the incidence of postoperative nausea and vomiting in patients of both study groups, we found that a decrease in the dose of perioperative use of opioids helps to reduce the incidence of this complication, which increased the safety of anesthetic management, greatly facilitated and accelerated the rehabilitation of patients after laparoscopic kidney surgery. The work also highlighted and systematized information on the morphology of structures involved in the formation of postoperative nausea and vomiting, on the physiology of this process

scholarly journals Impact of low-opioid anesthesia on the incidence of postoperative nausea and vomiting during laparoscopic kidney surgery

2021 ◽  
Vol 17 (2) ◽  
pp. 42-48
Author(s):  
T.V. Ovsiienko ◽  
M.V. Bondar ◽  
O.A. Loskutov
Keyword(s):  
General Anesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Average Dose ◽  
Kidney Surgery ◽  
Entire Time ◽  
Group 3 ◽  
Group 2 ◽  
Total Average

Background. The problem of postoperative nausea and vomiting has attracted the attention of specialists in various fields of surgery and anesthesiology for a long time and has not lost its relevance today, being the subject of active discussion in domestic and foreign literature. It can become an independent cause of other quite serious postoperative complications. The article presents the results of our own study of the use of multimodal low-opioid general anesthesia as one of the methods for the prevention of postoperative nausea and vomiting during anesthetic provision of laparoscopic kidney surgery. Materials and methods. The study involved 50 patients who underwent laparoscopic kidney surgery. To compare the incidence of postoperative nausea and vomiting, patients were randomly divided into three groups. Group 1 (control group) used multimodal general anesthesia with standard doses of opioids; group 2 used multimodal low-opioid general anesthesia with lidocaine, and group 3 used multimodal low-opioid anesthesia with dexmedetomidine. Results. The total average dose of fentanyl used during the entire time of anesthesia in the control group was 373.3 ± 50.8 μg (4.34 μg/kg/h). The total average dose of fentanyl used during the entire time of anesthesia in group 2 was 217.39 ± ± 49.1 μg (1.76 μg/kg/h). The total average dose of fentanyl used during the entire time of anesthesia in group 3 was 308.33 ± ± 51.49 µg (2.44 µg/kg/h). In group 1, vomiting in the postoperative period occurred in 4 patients out of 15 (26.7 % of cases), in group 2 — in 4 patients out of 23 operated (17.4 % of cases), in group 3 — in 1 patient out of 12 (8.3 % of cases). Conclusions. As a result of comparing the incidence of postoperative nausea and vomiting in the patients of the studied groups, it was found that a decrease in the dose of perioperative use of opioids helps to reduce the incidence of this complication, increases the safety of anesthesia, significantly facilitates and accelerates the rehabilitation of patients after laparoscopic surgery on the kidneys.

scholarly journals Comparison of the Efficacy of Metoclopramide Versus Dexamethasone for the Prevention of Postoperative Nausea Vomiting during General Anesthesia

2021 ◽  
pp. 163-168
Author(s):  
Sunil Arjan ◽  
Naila Zahoor ◽  
Kenza Nadeem ◽  
Farah Liaquat ◽  
Tariq Hussain Mughal ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Female Ratio ◽  
Post Operative Nausea ◽  
Group D ◽  
Male To Female

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.

scholarly journals Comparison of Anesthesia Depth Monitoring using Conventional and Bispectral Index on Incidence and Severity of Nausea and Vomiting after Urological Surgeries

2018 ◽  
Vol 6 (2) ◽  
pp. 25
Author(s):  
Reihan Shenasi ◽  
Hamzeh Hoseinzadeh ◽  
Hasan Mohammadpor-Anvari ◽  
Davod Aghamohammadi ◽  
Reza Sari-Motlagh
Keyword(s):  
General Anesthesia ◽  
Bispectral Index ◽  
Postoperative Nausea ◽  
Operating Time ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Anesthetic Drugs ◽  
Urological Surgery ◽  
Anesthesia Depth

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

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