scholarly journals A study to assess the effects of a single preoperative dose of steroid on thyroidectomy

2017 ◽  
Vol 4 (6) ◽  
pp. 1959
Author(s):  
Jose Gamalial ◽  
Jacob P. Thomas ◽  
Sarosh Janardanan
Keyword(s):  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Age Group ◽  
Inclusion Criteria ◽  
Dose Administration ◽  
Vocal Function ◽  
Medical College ◽  
Pain Scores ◽  
Group D

Background: On thyroidectomy, incidence of postoperative nausea and vomiting, severe pain with local inflammation and voice impairment was very common. These effects can be manipulated by the use of steroids. Hence the present study, was conducted with the objective to evaluate the effects of a single preoperative dose of dexamethasone on thyroidectomy in terms of postoperative nausea and vomiting (PONV), pain and voice improvement.Methods: The present study was conducted between October 2010 and March 2011 at the Department of General Surgery, Government Medical College, Kottayam, Kerala, India. A total of 72 patients were included in the study after meeting requirements of inclusion criteria. They were divided into two groups. 37 were under Group C and received normal saline and remaining 35 served as Group D and received 8 mg/2 mL of dexamethasone preoperatively. Post-operative incidences of nausea and vomiting, pain scores, and the improvement of vocal function were compared in both groups.Results: Out of 72 patients, most of the patients participated were under the age group of 40-50 years (30.6%). Of them 9 were males and 63 were females. The incidence and severity of PONV and pain was significantly reduced in Group D compared to Group C with P values of 0.001 and 0.056 respectively. Significant protection of dexamethasone towards vocal function was not observed in the study (p =0.245).Conclusions: From the results obtained in the study, it was concluded that preoperative single dose administration of dexamethasone seemed to be safe in healthy patients undergoing thyroidectomy.

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 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 The experience of using dexmedetomidine as an adjuvant of anesthesia in ophthalmic surgery

2021 ◽  
Vol 26 (1) ◽  
pp. 128-135
Author(s):  
N.V. Mynka ◽  
Yu.Yu. Kobelyatskyy
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Postoperative Nausea ◽  
Corneal Transplantation ◽  
Postoperative Nausea And Vomiting ◽  
Pain Syndrome ◽  
Nausea And Vomiting ◽  
Ophthalmic Surgery ◽  
Intraoperative Pain ◽  
Group D

Various techniques are applied to reduce the severity of postoperative pain and discomfort in patients. The purpose of this research work was to evaluate the effectiveness and safety of Dexmedetomidine as an adjuvant of anesthesia in ophthalmic surgery. The study included 80 patients who underwent  corneal transplantation on the basis of Dnepropetrovsk Regional Clinical Ophthalmologic Hospital. Patients were divided into 2 groups: control (group K) – 30 men and main (group D) – 50 ones. Multicomponent balanced anesthesia was applied in both groups. Sibazone was administered as the sedative medicine in the group K, Dexmedetomedin was administered in the group D. The main criteria for evaluating the research results were hallmarked: hemodynamic stability during surgery, the amount of administered opiates, the severity of intraoperative pain syndrome by evaluating the ANI index (ANI – analgesia nociception index), the severity of postoperative pain syndrome and the frequency of postoperative nausea and vomiting (PONV). Both schemes of anesthesia allowed avoiding pronounced fluctuations in hemodynamic parameters and gas exchange at all stages of the study. Analyzing the severity of intraoperative pain, we found that in group K pain relief could be considered insufficient during the first 7 minutes of the most traumatic stage of the surgery, while in group D the ANI index did not fall below 50. Statistically significant differences were obtained on minute 1, 2, 5, 6, and 7 of the surgery. The number of episodes of insufficient anesthesia during the most traumatic stage of the surgery in group K was statistically significantly higher than in group D. Analyzing the quality of pain relief in the postoperative period it was determined, that the level of pain on the Visual Analog Scale (VAS) after awakening in both groups was equal to 0. At the next three stages of the study (2 hours, 6 hours after surgery, and the next morning), the level of pain in group K was significantly higher than in group D. In addition, it was determined that the need for narcotic analgesics and the number of episodes of postoperative nausea and vomiting in group K was statistically significantly higher than in group D. These given data allow us to conclude that Dexmedetomedin is the effective adjuvant of the anesthesia for corneal transplantation.

scholarly journals A comparative study of glycopyrrolate and dexamethasone in the control of postoperative nausea and vomiting after intrathecal fentanyl and bupivacaine for caesarean section

2021 ◽  
Vol 9 (5) ◽  
pp. 1236
Author(s):  
Ikemefuna P. Okonkwo ◽  
Fidelis A. Onyekwulu
Keyword(s):  
Side Effects ◽  
Caesarean Section ◽  
Postoperative Nausea ◽  
Elective Caesarean Section ◽  
Postoperative Nausea And Vomiting ◽  
Likert Scale ◽  
Nausea And Vomiting ◽  
Controlled Study ◽  
Biophysical Profile ◽  
Group D

Background: Postoperative nausea and vomiting (PONV) is an undesirable outcome that parturient who undergo caesarean section experience. We compare the efficacies of IV glycopyrrolate and IV dexamethasone as prophyaxis against PONV in these paturient.Methods: This was a prospective, randomized, double blind placebo-controlled study of seventy six (76) ASA II patients aged 18-40 years who underwent elective caesarean section under spinal anaesthesia. Patients were randomly allocated to three groups, group G (glycopyrrolate): n=26, group D (dexamethasone): n=25 and group C (control; normal saline): n=25. Data collection was with the aid of a proforma which included the biophysical profile, Belville scoring scale for PONV, Likert scale was used for patient satisfaction and side effects were also documented. The data were analyzed using SPSS version 17 and presented in tables and figures.Results: The demographic characteristics and mallampati scores of patients in all 3 groups were similar. The results showed that the incidence of PONV in group D was 8%, in group G 19.2% and in group C 32% (p= 0.048, OR= 0.185, 95% C.I for OR= 0.035 – 0.983). All patients expressed satisfaction in the care they received as assessed using the Likert scale and only patients who received IV glycopyrrolate experienced side effects in the form of dryness of the mouth. There were no side effects reported in patients who received IV dexamethasone.Conclusions: The study demonstrated that IV dexamethasone 8mg was more effective in controlling PONV after intrathecal fentanyl and bupivacaine for caesarean section when compared to 0.2 mg IV glycopyrrolate.

scholarly journals INFLUENCE OF CYTOCHROME P-450 GENETIC POLYMORPHISMS ON THE MAIN AND SIDE EFFECTS OF TRAMADOL IN THE POSTOPERATIVE PERIOD

2017 ◽  
Vol 11 (4) ◽  
pp. 240-246
Author(s):  
D. A Sokolov ◽  
Pavel A. Lyuboshevskiy ◽  
A. N Ganert
Keyword(s):  
Postoperative Nausea ◽  
Active Metabolite ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Cyp2d6 Gene ◽  
Pain Scores ◽  
Drug Biotransformation ◽  
Group 2 ◽  
Α Angle ◽  
Cytochrome P 450

One of the approaches to increasing the effectiveness and safety of postoperative analgesia can be its personification. The goal of the study was to evaluate the efficacy of tramadol analgesia depending on the polymorphisms of the CYP2D6 gene, the cytochrome P-450 isoenzyme, involved in drug biotransformation into the active metabolite. 96 patients with elective endoscopic gynecology procedures were examined. Polymorphisms G1846A and C100T, which reduce the activity of the isoenzyme CYP2D6, were detected, and the intensity of postoperative pain, the autonomic nervous system state by cardiointervalography and hemostasis using rotational thromboelastometry were evaluated. Polymorphisms were detected in 29 (30.2%) patients, united in the 1-st group. The second group consisted of 67 patients without gene polymorphisms. Patients with polymorphisms have a higher pain scores; the frequency of postoperative nausea and vomiting, on the contrary, was significantly lower. According to cardiointervalography, sympathicotonia was observed in Group 1 patients after surgery, while in Group 2 patients the indices did not change significantly compared to baseline. The parameters of hemostasis in patients of the 2nd group were characterized by moderate hypercoagulability (shortening of clotting time and clot formation time), whereas in the firsts group, relative hypocoagulation (decrease in α angle, and clot firmness) was noted. Conclusion. In female carriers of G1846A and C100T polymorphisms of the CYP2D6 gene, the effectiveness of post-operative analgesia based on tramadol is reduced. They have a lower incidence of postoperative nausea and vomiting, and moderate hypocoagulation. Probably, these phenomena are associated with a change in the ratio between the drug and its active metabolite - O-desmethyltramadol.

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.

Dexamethasone Versus Ondansetron in Preventing Postoperative Nausea and Vomiting In Laparoscopic Surgery

2021 ◽  
Vol 17 (3) ◽  
pp. 222-226
Author(s):  
Anum Malik ◽  
Arshad Shahani ◽  
Jawad Zahir ◽  
Hassam Zulfiqar ◽  
Tabassum Aziz
Keyword(s):  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
P Value ◽  
Inclusion Criteria ◽  
Significant Difference ◽  
Quasi Experimental ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: To compare the efficacy of dexamethasone 8mg versus ondansetron 4mg in preventing postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy Methodology: This quasi-experimental study was conducted at the Department of Anaesthesia and Intensive Care, Holy Family Hospital from 29th July 2018 to 28th January 2019.  Anesthesia was induced with propofol (2mg/kg IV) and Atracurium (0.5 mg/kg IV) was given to facilitate tracheal intubation. Nalbuphine (0.2mg/kg) was used as analgesic.Patients were randomly divided into two groups. Patients in Group A received 4mg ondansetron at end of surgery and Group B received 8mg dexamethasone at induction. Results: A total of 90 patients were included according to the inclusion criteria of the study. The mean age (years) in the study was 37.11+10.60 years. Frequency and percentage of nausea (up to 24 hours) among both the groups was 28 (62.2) and 28 (62.2) respectively (p-value = 1.0) while the frequency and percentage of vomiting (within 24 hours after extubation) was 28 (62.2) and 27 (60.0) respectively (p-value = 0.829) Conclusion: The study concluded that there was no significant difference dexamethasone and ondansetron in preventing postoperative nausea and vomiting.

COMPARISON OF EFFECTIVENESS AMONG ONDANSETRON, PALONOSETRON AND GRANISETRON IN PREVENTING POSTOPERATIVE NAUSEAAND VOMITING FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
pp. 65-67
Author(s):  
Amrit Ghosh ◽  
Arabinda Mazumdar ◽  
Sujan Sarkar ◽  
Ashim Mandal ◽  
Debarshi Jana
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Postoperative Vomiting ◽  
Medical College ◽  
Effective Prophylaxis ◽  
Elective Laparoscopic Cholecystectomy ◽  
Comparison Of Effectiveness ◽  
Double Blinded

Postoperative nausea and vomiting (PONV) has been variously described as the “big little problem” the “nal therapeutic challenge” for anaesthesiology. The commonest cause of morbidity after anaesthesia and surgery are pain and postoperative nausea vomiting 1. To compare the incidences of PONV following laparoscopic cholecyetectomy in different groups of patients receiving ondansetron, palonosetron and Granisetron. 2. To identify the better strategy for prevention of PONV. This is a prospective randomized double blinded clinical study. Both patient and observer were blinded to the group allocation. Allocations to three groups were strictly condential and concealed. One and half year (18 months). Patients undergoing elective laparoscopic cholecystectomy under General Anaesthesia at General Surgery operation theatres of Bankura Sammilani Medical College and Hospital, Bankura The effects of palonosetron, granisetron and ondansetron in preventing PONV (postoperative nausea vomiting) were compared in patients undergoing laparoscopic cholecystectomy and it was found that palonosetron was best and granisetron better in comparison with ondansetron in preventing postoperative nausea and vomiting. Palonosetron provides more effective prophylaxis of early PON (postoperative nausea), late PON (postoperative nausea), and late POV (postoperative vomiting) compared with granisetron and ondansetron. Palonosetron could provide effective prophylactic antiemetic control to prevent PONVafter laparoscopic cholecystectomy surgery under general anesthesia.

scholarly journals Is Infusion of Subhypnotic Propofol as Effective as Dexamethasone in Prevention of Postoperative Nausea and Vomiting Related to Laparoscopic Cholecystectomy? A Randomized Controlled Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Mine Celik ◽  
Aysenur Dostbil ◽  
Mehmet Aksoy ◽  
Ilker Ince ◽  
Ali Ahiskalioglu ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Controlled Trial ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Controlled Study ◽  
Control Group ◽  
Double Blind ◽  
Significant Difference ◽  
Group D

Background. Postoperative nausea and vomiting (PONV) is one of common complications in patients undergoing laparoscopic cholecystectomy (LC). Aim of this study was to compare the efficacy of subhypnotic (1 mg/kg/h) infusion of propofol with dexamethasone on PONV in patients undergoing LC.Methods. A total of 120 patients were included in this randomized, double-blind, placebo-controlled study. Patients were randomly assigned to 3 groups; patients of group dexamethasone (group D) were administrated 8 mg dexamethasone before induction of anesthesia, patients of group propofol (group P) were infused to subhypnotic (1 mg/kg/h) propofol during operation and patients of group control (group C) were applied infusion of 10% intralipid. The incidence of PONV and needs for rescue analgesic and antiemetic were recorded in the first 24 h postoperatively.Results. In the 0–24 h, the incidence of PONV was significantly lower in the group D and group P compared with the group C (37.5%, 40%, and 72.5%, resp.). There was no significant difference in the incidence of PONV and use of antiemetics and analgesic between group D and group P.Conclusion. We concluded that infusion of propofol 1 mg/kg/h is as effective as dexamethasone for the prevention of PONV during the first 24 hours after anesthesia in patients undergoing LC.

scholarly journals Antiemetic prophylaxis against postoperative nausea and vomiting with ondansetron-dexamethasone combination compared to ondansetron or dexamethasone alone for patients undergoing laparoscopic cholecystectomy

1970 ◽  
Vol 6 (3) ◽  
pp. 319-328 ◽  
Author(s):  
B Gautam ◽  
BR Shrestha ◽  
P Lama ◽  
S Rai
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Complete Response ◽  
Nausea And Vomiting ◽  
General Anaesthetic ◽  
Antiemetic Prophylaxis ◽  
Dexamethasone Group ◽  
Group D ◽  
Rescue Antiemetic

Background: Postoperative nausea and vomiting (PONV) is a common distressing experience in patients following laparoscopic surgeries. This study was aimed at comparing the efficacies of Ondansetron-Dexamethasone combination with each drug alone as a prophylaxis against PONV in patients after elective laparoscopic cholecystectomy done under general anaesthesia. Materials and methods: Hundred and fifty ASA I and II patients, aged 23 to 65 yrs, were enrolled in this prospective, randomized, double-blind trial to receive one of three treatment regimens: 4 mg Ondansetron (Group O), 8 mg Dexamethasone (Group D) or 4 mg Ondansetron plus 8 mg Dexamethasone (Group OD) (n=50 for each). A standardized balanced general anaesthetic technique was employed. Any episode of PONV and need for rescue antiemetic were assessed at six, 12 and 24 hrs post operation. Complete response was defined as no PONV in 24 hrs and need for rescue antiemetic was considered as failure of prophylaxis. Pain scores, time to first analgesia demand, amount of Meperidine consumption, adverse event(s) and duration of hospital stay were recorded. Results: Complete response occurred in 66.7, 66.0 and 89.4% in Groups O, D and OD respectively. Rescue antiemetics were required in 29.2, 31.9 and 8.5% of patients in Groups O, D, and OD respectively. Significantly high incidence of vomiting and failure of prophylaxis (19.1%) occurred in group D during the first six hrs (P=0.023 versus O & 0.008 versus OD). More frequent antiemetic rescue was required in group O at 6 to 24 hr interval as compared to group OD (P=0.032). Conclusion: Combination of Ondansetron and Dexamethasone is better than each drug alone in preventing PONV after laparoscopic cholecystectomy. Dexamethasone alone is significantly less effective in preventing early vomiting compared to its combination with Ondansetron; whereas Ondansetron alone is less effective against late PONV as compared with combination therapy. Key words: Antiemetic prophylaxis; Dexamethasone; laparoscopic cholecystectomy; Ondansetron; postoperative nausea and vomiting (PONV) doi: 10.3126/kumj.v6i3.1706 Kathmandu University Medical Journal (2008), Vol. 6, No. 3, Issue 23, 319-328

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