scholarly journals A COMPARISON OF INTRAVENOUS ONDANSETRON AND PALONOSETRON IN PREVENTING POST-OPERATIVE NAUSEA AND VOMITING AFTER LAPAROSCOPIC CHOLECYSTECTOMY - A RANDOMIZED DOUBLE-BLIND STUDY

2018 ◽  
Vol 11 (12) ◽  
pp. 128
Author(s):  
Ajay Kumar ◽  
Sumita Adhana ◽  
Puneet Dwivedi
Keyword(s):  
Patient Satisfaction ◽  
Laparoscopic Cholecystectomy ◽  
Side Effect ◽  
Nausea And Vomiting ◽  
Side Effect Profile ◽  
Time Intervals ◽  
Patient Satisfaction Scores ◽  
Number Of Patients ◽  
Post Operative Nausea ◽  
Rescue Antiemetic

Objectives: Post-operative nausea and vomiting (PONV) is a frequently experienced complication following laparoscopic cholecystectomy. This study was planned to compare the antiemetic efficacy of palonosetron with ondansetron in patients undergoing laparoscopic cholecystectomy.Methods: A total of 100 patients undergoing laparoscopic cholecystectomy were randomized into two groups. Group O (n=50) received ondansetron (8 mg) and Group P (n=50) received palonosetron (0.075 mg) 3 min before induction of anesthesia. Post-operatively, patients were assessed for the occurrence of nausea, retching, or vomiting at 0–2, 2–6, 6–24, 0–24, and 24–48 h time intervals. The overall incidence of PONV in time frame (0–48 h) was determined. The need of rescue antiemetic, side effect profile, and patient satisfaction scores were also assessed.Results: The incidence and severity of nausea at all the time intervals were comparable in the two groups. The incidence of vomiting was significantly less in Group P as compared to Group O in 0–2 h (2% vs. 14%, p=0.027) and 0–24 h time intervals (10% vs. 30%, p=0.012). The overall incidence of PONV in 0–48h was lesser in Group P as compared to Group O (28% vs. 50%, p=0.024). Rescue antiemetic was required in greater number of patients in Group O as compared to Group P (p=0.038). Side effect profile and patient satisfaction scores were comparable in the two groups.Conclusion: Palonosetron is better than ondansetron in lowering the overall incidence of PONV in 0–48 h time interval, in patients undergoing laparoscopic cholecystectomy.

Dexamethasone in Combination with Dolasetron for Prophylaxis in the Ambulatory Setting

2002 ◽  
Vol 96 (6) ◽  
pp. 1346-1350 ◽  
Author(s):  
Margarita Coloma ◽  
Paul F. White ◽  
Scott D. Markowitz ◽  
Charles W. Whitten ◽  
Amy R. Macaluso ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Quality Of Recovery ◽  
Dexamethasone Group ◽  
Patient Satisfaction Scores ◽  
Discharge Criteria

Background Postoperative nausea and vomiting after laparoscopic cholecystectomy remains a common problem despite routine antiemetic prophylaxis. Therefore, the authors investigated the effect of administering 4 mg intravenous dexamethasone as an adjunct to a 5-HT3 antagonist (12.5 mg intravenous dolasetron) with respect to patient outcome. Methods Outpatients (N = 140) were enrolled in this prospective, randomized, placebo-controlled, double-blind, institutional review board-approved protocol involving two antiemetic treatment groups. After induction of anesthesia, the control group received 1 ml intravenous saline, whereas the dexamethasone group received 4 mg intravenous dexamethasone. Both groups received 12.5 mg intravenous dolasetron at the time of gallbladder removal. A blinded observer recorded the recovery times, emetic episodes, rescue antiemetics, maximum nausea score, and time to achieve discharge criteria. Postdischarge side effects, as well as patient satisfaction and quality of recovery scores were assessed at 24 h after surgery. Results Although there was no difference in the incidence of postoperative nausea and vomiting in the early recovery period, the dexamethasone group had a shorter stay in the day-surgery unit (136 +/- 57 vs. 179 +/- 62 min) and more rapidly achieved discharge criteria (161 +/- 32 vs. 209 +/- 39 min). In addition, fewer patients in the dexamethasone group experienced nausea at home within 24 h after discharge (13 vs. 28%, P < 0.05). Finally, the dexamethasone group reported higher quality of recovery and patient satisfaction scores (P < 0.05). Conclusions The authors conclude that the adjunctive use of 4 mg intravenous dexamethasone shortened the time to achieve discharge criteria and improved the quality of recovery and patient satisfaction scores after laparoscopic cholecystectomy procedures in outpatients receiving prophylaxis with 12.5 mg intravenous dolasetron.

scholarly journals Intravenous Granisetron, Ondansetron and Metoclopramide in the Prevention and Treatment of Post Operative Nausea and Vomiting after Laparoscopic Cholecystectomy - A Comparative Study

2009 ◽  
pp. 20-27
Author(s):  
Sabina Yeasmeen ◽  
Rubina Yasmin ◽  
AKM Akhtaruzzaman ◽  
UH Shahera Khatun
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
General Anaesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Patients Satisfaction ◽  
Group I ◽  
Prevention And Treatment ◽  
Post Operative Nausea ◽  
Rescue Antiemetic

Postoperative nausea and vomiting are the common morbidity after general anaesthesia and surgery. One of the essential goals of anaesthetic management is to prevent postoperative nausea and vomiting. The consequence of prolonged postoperative nausea and vomiting (PONV) ranges from unexpected admission of day patients with its economic implications to physical, metabolic and psychological effects on the patients which slow their recovery and reduced their confidence in future surgery and anaesthesia. The present study was designed to compare the efficacy of Granisetron with that of Ondansetron and Metoclopramide in the treatment and prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. This study was also done to observe the incidence of nausea and vomiting in the postoperative period, to observe the requirement of rescue antiemetic, to find out the haemodynamic stability, saturation of arterial oxygen in these groups of subject and to detect the patients satisfaction by verbal rating scale after 24 hours of surgery. A total number of 90 patients, sex female, age range 30-50 years undergoing laparoscopic cholecystectomy were selected. They were equally divided into three groups of 30 patients. They received a standard general anaesthesia. Group I received injection Granisetron (1mg), Group II received injection Ondansetron (8mg), Group III received injection Metoclopramide (10mg) 10 minutes before reversal of anaesthesia. Postoperative analgesia was provided with injection pethidine (1.5mg/kg/bd.wt.) intramuscularly 8 hourly. In the recovery room occurrence of nausea and vomiting was assessed for 24 hours. The incidence of emesis free (no nausea) was significantly higher in patients who received Ganisetron (90.0%, 27/ 30) than in those who received Ondansetron [(66.7%, 20/30), p=0.028] or metoclopramide [(40.0%, 12/30), p= 0.000].The incidence of vomiting free was significantly higher in patients who received Granisetron (93.3%, 28/30) than in those who received Ondansetron [73.3%, 22/30), p= 0.037] or Metoclopramide [46.7%, 14/30), p= 0.000]. Granisetron was associated with greater patients' satisfaction than Ondansetron and Metoclopramide 40%, 20% and 10% of patients respectively. No need for another rescue antiemetic medication was achieved in 86.7% of patients with granisetron, 70.60% with Ondansetron and 53.3% with Metoclorpramide. The haemodynamic variables, heart rate, blood pressure, SpO2 were recorded carefully in different time intervals. There was no significant difference among the study. So, it can be concluded that Granisetron is more effective than Ondansetron and Metoclopramide in the prevention and treatment of postoperative nausea and vomiting after laparoscopic cholecystectomy. Journal of BSA, Vol. 19, No. 1 & 2, 2006 p20-27

scholarly journals Comparative study of acupressure wristband versus palonosetron for prophylaxis of postoperative nausea and vomiting in elective laparoscopic cholecystectomy under general anaesthesia

2016 ◽  
Vol 5 (1) ◽  
pp. 96 ◽  
Author(s):  
Suchismita Naik ◽  
Shweta Kujur ◽  
Miltan Debbarma ◽  
Miltan Debbarma ◽  
Madhumita G. Murthy
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
General Anaesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
P Value ◽  
Double Blind Study ◽  
Post Operative Nausea ◽  
Rescue Antiemetic ◽  
Wrist Bands

Background: Postoperative nausea and vomiting (PONV) is common complication after general anesthesia and surgery. This randomized double-blind study was designed to compare the effects of acupressure wrist bands and palonosetron for the prevention of post-operative nausea and vomiting (PONV) in laparoscopic cholecystectomy under general anaesthesia.Methods: Sixty ASA I and II patients undergoing elective laparoscopic surgeries under general anaesthesia were divided into two groups. In Group A patients, acupressure wrist bands were applied on p6 point on both hands half an hour before induction. Group P patients received inj. palonosetron 0.075 m.g. i.v. just before induction. Anaesthesia technique was standardized. Post-operatively patients were monitored for nausea, retching or vomiting upto 24 hours. If patients vomited more than once, they were given inj. Metoclopramide 10mg as rescue antiemetic. Efficacy of drugs was compared using Chi square test. ‘p’ value of <0.05 is considered significant.Results: The incidence of PONV and requirement of rescue antiemetic were lower in palonosetron group than acupressure wrist band group.Conclusions: Palonosetron is more effective than acupressure wrist band for prophylaxis of post- operative nausea and vomiting in the patients undergoing laparoscopic cholecystectomy under general anaesthesia, but acupressure wrist band can also be used as an alternative non-pharmacological method.

scholarly journals Comparison of 3 Approaches to Percutaneous Epidural Adhesiolysis and Neuroplasty in Post Lumbar Surgery Syndrome

2018 ◽  
Vol 1 (21;1) ◽  
pp. E501-E508
Author(s):  
Haitham Hamdy Salem
Keyword(s):  
Patient Satisfaction ◽  
Pain Relief ◽  
Group Analysis ◽  
Pain Severity ◽  
University Hospital ◽  
Pain Clinic ◽  
Complication Rates ◽  
Lumbar Surgery ◽  
Time Intervals ◽  
Number Of Patients

Background: Percutaneous epidural adhesiolysis and neuroplasty (PEAN) has been proven to be safe and effective in treating different spine pathologies, in particular post lumbar surgery syndrome (PLSS). Objectives: The purpose of this study was to compare the efficacy and complication rates of the 3 different PEAN anatomical approaches (caudal, S1 foraminal, and L5-S1 transforaminal) used to treat PLSS. Study Design: This study used a case control, blind study. Setting: The research took place at the pain clinic and interventional pain practice room at Asyut University Hospital, Assiut, Egypt. Methods: Sixty consecutive PLSS patients were recruited and randomized into 3 groups (caudal, S1 foraminal, and L5-S1 transforaminal) before receiving adhesiolysis and neuroplasty. All patients underwent nerve conduction studies and magnetic resonance imaging (MRI). Pain severity levels were assessed and measured using the Oswestry Disability Questionnaire (OSW) and the Visual Analog Scale (VAS). Patient satisfaction was evaluated using a Likert scale. The first assessment was performed prior to the procedure to determine the patients’ baseline levels of pain severity. Followup assessments were performed 1-, 3-, and 6-months after the procedure. Results: Results of the group pairwise analysis indicated that, relative to baseline, there were significant decreases in pain relief scores (VAS and OWS) and functional assessment expressed by patients’ satisfaction across all time intervals and in all 3 groups (P < 0.01). Conversely, a between group analysis revealed that VAS, OWS, and patient satisfaction scores were comparable across the 3 groups at all time intervals (P > 0.05). There were no differences in rates of complications between the 3 different groups. Limitations: Our study was limited by the low number of patients and the short duration (6 months) of follow-up. Conclusion: The 3 anatomical approaches (caudal, S1 foraminal, and L5-S1 transforaminal) result in the same outcome with regard to pain relief and complication rate. Key words: Post lumber surgery syndrome, post laminectomy back pain, percutaneous adhesiolysis, Racz catheter, percutaneous neuroplasty

scholarly journals Post operative nausea and vomiting after laparoscopic cholecystectomy: comparison of prophylactic effect of dexamethasone with ondansetron

2014 ◽  
Vol 24 (2) ◽  
pp. 60-64
Author(s):  
M Younus Ali ◽  
Raihan Uddin ◽  
Amirul Islam ◽  
Mustafa Kamal ◽  
SM Rafiqul Islam ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Vital Signs ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Group A ◽  
The Difference ◽  
Prophylactic Use ◽  
Group B ◽  
Post Operative Nausea

Background Postoperative nausea and vomiting after laparoscopic cholecystectomy under general anaesthesia are an unpleasant,distressing effects. Prophylactic use of dexamethesone reducing this effects. Objective This study was designed to compare of dexamethasone and ondansetron for prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. Methods Sixty patients who underwent laparoscopic cholesystectomy were randomly allocated into two groups. Group A(n=30) patients received 8mg dexamehtasone intravenously and Group B(n=30) patients received 8mg ondansetron intravenously one minute before induction of anaesthesia. All patients received standard general anaesthesia.Perioperative vital signs and postoperative nausea and vomiting were recorded. Results The incidence of nausea was 13.4% in group A, 16.7% in group B(p>0.05) and vomiting was 6.6% in Group A, 13.4% in group B(p>0.05). The difference among the groups was not statistically significant. Conclusion Intravenous dexamethasone was better to ondansetron in prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. DOI: http://dx.doi.org/10.3329/jbsa.v24i2.19803 Journal of Bangladesh Society of Anaesthesiologists 2011; 24(2): 60-64

scholarly journals Investigation of the Effects of Preoperative Hydration on the Postoperative Nausea and Vomiting

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
M. Selçuk Yavuz ◽  
Dilek Kazancı ◽  
Sema Turan ◽  
Bahar Aydınlı ◽  
Gökçe Selçuk ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Number Of Patients ◽  
Significant Difference ◽  
Intravenous Fluid Administration ◽  
Intravenous Hydration ◽  
Vas Scores ◽  
Group 2

Introduction. Postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy operations still continue to be a serious problem. Intravenous fluid administration has been shown to reduce PONV. Some patients have higher risk for PONV described by APFEL score. In this study, our aim was to determine the effects of preoperative intravenous hydration on postoperative nausea and vomiting in high Apfel scored patients undergoing laparoscopic cholecystectomy surgery.Patients and Methods. This study is performed with 50 female patients who had APFEL score 3-4 after ethics committee approval and informed consent was taken from patients. The patients were divided into 2 groups: group 1 (P1): propofol + preoperative hydration and group 2 (P2): propofol + no preoperative hydration.Results. When the total nausea VAS scores of groups P1and P2to which hydration was given or not given were compared, a statistically significant difference was detected at 8th and 12th hours (P=0.001andP=0.041). It was observed that in group P1, which was given hydration, the nausea VAS score was lower. When the total number of patients who had nausea and vomiting in P1and P2, more patients suffered nausea in P2group.Discussion. Preoperative hydration may be effective in high Apfel scored patients to prevent postoperative nausea.

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