scholarly journals IPMO Guidelines; Improved Perioperative Management and Outcomes Postoperative Pain Management and Postoperative Nausea and Vomiting Management

2010 ◽  
Vol 30 (3) ◽  
pp. 410-419
Author(s):  
Masahiro TAKAHASHI ◽  
Aya NISHIMURA ◽  
Hitoshi FURUYA
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Postoperative Nausea ◽  
Perioperative Management ◽  
Postoperative Nausea And Vomiting ◽  
Postoperative Pain Management ◽  
Nausea And Vomiting

Prospective evaluation of anesthetic protocols during pediatric ophthalmic surgery

2018 ◽  
Vol 29 (6) ◽  
pp. 606-614 ◽  
Author(s):  
Jean-Baptiste Ducloyer ◽  
Chloé Couret ◽  
Cécile Magne ◽  
Corinne Lejus-Bourdeau ◽  
Michel Weber ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Strabismus Surgery ◽  
Nausea And Vomiting ◽  
Ophthalmic Surgery ◽  
Oculocardiac Reflex ◽  
Locoregional Anesthesia ◽  
The Mean ◽  
Congenital Cataract Surgery

Purpose: To date, no protocol of anesthesia for pediatric ophthalmic surgery is unanimously recognized. The primary anesthetic risks are associated with strabismus surgery, including oculocardiac reflex, postoperative nausea and vomiting, and postoperative pain. Methods: This was a prospective, monocentric, observational study conducted in a tertiary pediatric ophthalmic unit. Our anesthetic protocol for strabismus surgery included postoperative nausea and vomiting prevention using dexamethasone and ondansetron. No drug-based prevention of oculocardiac reflex or local/locoregional anesthesia was employed. Results: A total of 106 pediatric ophthalmic surgeries completed between November 2015 and May 2016 were analyzed. The mean patient age was 4.4 (range: 0.2–7.3, standard deviation: 2.4) years. Ambulatory rate was 90%. Oculocardiac reflex incidence was 65% during strabismus surgery (34/52), 50% during congenital cataract surgery (4/8), 33% during intramuscular injection of botulinum toxin (1/3), and 0% during other procedures. No asystole occurred. Postoperative nausea and vomiting incidence was 9.6% after strabismus surgery (5/52) and 0% following the other procedures. One child was hospitalized for one night because of persistent postoperative nausea and vomiting. Postoperative pain generally occurred early on in the recovery room and was quickly controlled. Its incidence was higher in patients who underwent strabismus surgery (27%) than in those who underwent other procedures (9%). Conclusion: Morbidity associated with ophthalmic pediatric surgery is low and predominantly associated with strabismus surgery. The benefit–risk ratio and cost-effectiveness of oculocardiac reflex prevention should be questioned. Our postoperative nausea and vomiting rate is low, thanks to the use of a well-managed multimodal strategy. Early postoperative pain is usually well-treated but could probably be more effectively prevented.

scholarly journals Efficacy of Three Different Prophylactic Treatments for Postoperative Nausea and Vomiting after Vitrectomy: A Randomized Clinical Trial

2019 ◽  
Vol 8 (3) ◽  
pp. 391 ◽  
Author(s):  
Michele Reibaldi ◽  
Matteo Fallico ◽  
Antonio Longo ◽  
Teresio Avitabile ◽  
Marinella Astuto ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Adverse Events ◽  
Local Anesthesia ◽  
Postoperative Nausea ◽  
Therapy Group ◽  
Combined Therapy ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Combination Group

Postoperative nausea and vomiting (PONV) after vitreoretinal surgery may potentially be associated with severe complications, such as suprachoroidal hemorrhage. The purpose of the present multicenter clinical trial (NCT02386059) was to assess the efficacy of three different prophylactic treatments for PONV after vitrectomy under local anesthesia. Patients undergoing primary vitrectomy were randomized to the control arm or to one of the treatment arms (4 mg ondansetron, 4 mg dexamethasone, combination of the two drugs). The primary outcome measure was the proportion of complete response (no nausea, no vomiting, no retching, and no use of antiemetic rescue medication) during 24 h after vitrectomy. Secondary outcomes included the severity standardized score of PONV, postoperative pain standardized score, and rate of ocular and non-ocular adverse events. Baseline demographics of the 1287 patients were comparable between the four arms. The combined therapy group showed a statistically significant lower incidence of PONV compared to the placebo and monotherapy (p < 0.001). PONV severity was also reduced in the combination group compared to the others (p < 0.001). Postoperative pain scores and adverse events were comparable among the four groups. Combined therapy with dexamethasone and ondansetron was the most effective treatment for reducing the incidence and severity of PONV in patients undergoing vitrectomy under local anesthesia.

scholarly journals Postoperative Pain Management in Patients With Ulcerative Colitis

2020 ◽  
Vol 67 (3) ◽  
pp. 158-163
Author(s):  
Norika Katagiri ◽  
Ryutaro Sakai ◽  
Takashi Izutsu ◽  
Hiromasa Kawana ◽  
Shigekazu Sugino ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Pain Management ◽  
Postoperative Pain ◽  
Maxillofacial Surgery ◽  
Postoperative Nausea And Vomiting ◽  
Postoperative Pain Management ◽  
Oral And Maxillofacial Surgery ◽  
Patient Controlled Analgesia ◽  
Inflammatory Bowel ◽  
Inflammatory Drugs

Inflammatory bowel disease (IBD) is a group of chronic inflammatory disorders of the gastrointestinal tract including ulcerative colitis (UC) and Crohn's disease. Pain management can be challenging in patients with IBD because there are limitations on the use of analgesics. Use of nonsteroidal anti-inflammatory drugs is not recommended in patients with IBD because there is risk of relapse of IBD and an overall increase in disease activity. Opioids, although frequently used for treating severe acute pain, can have additional risks and complications in patients with IBD such as ileus, toxic megacolon, and narcotic bowel syndrome. Furthermore, little information is available in the literature on pain management in these patients undergoing noncolorectal surgery. This report describes 2 patients with UC in whom postoperative pain following oral and maxillofacial surgery was managed by intravenous patient-controlled analgesia with pentazocine. Apart from the development of acute dystonia in 1 case that was likely due to the use of droperidol for prevention of postoperative nausea and vomiting, postoperative pain was well controlled by pentazocine in both patients without any complications or UC exacerbations.

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.

Sign in / Sign up

Export Citation Format

Share Document