scholarly journals The Impact of Different Antiemetics on the Nausea in Early Postoperative Period after Laparoscopic Holecystectomy

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Goran Marijanovic ◽  
Ljubica Radunovic
Keyword(s):  
Postoperative Period ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Early Postoperative Period ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Preventive Strategies ◽  
Dexamethasone Treatment ◽  
Dexamethasone Group ◽  
The Impact

Abstract Postoperative nausea and vomiting (PONV) is a patient-important outcome; patients often rate PONV as worse than postoperative pain. This clinical study was aimed to asses the efficiency of standard aniemetics administration separately or in combination in prevention of PONV in patients who underwent to the same surgical procedure - laparoscopic cholecystectomy. Also, this article could provide a novel information about the best choice for prevention and treatment of PONV. This study included 87 patients divided into four groups according to the postoperative phramacological treatment: First group was control group without treatment, Second group was group of patients with ondasetron treatment in postoperative period, Third group was group of patients with ondasetron+dexamethasone treatment, and fourth group was group of patients with dexamethasone treatment in postoperative period for nausea. PONV was distributed in Ondansetron+Dexamethasone group in the lowest percent (4.5%), which means that this conbination of antiemetics was very effective. Than, Dexamethasone group was in relation with low incidence of PONV (14.3%), and after that were Ondansetron and Control groups. Also smokers and males has lower incidence of PONV, especially in combination with Ondansetron+Dexamethasone treatment. The incidence of PONV is lower in male smokers patients who were underwent to combination of two antiemetics, ondansetron and dexamethasone compared to monotherapy and female non-smokers. Preventive strategies for PONV must include risk stratification followed by prophylactic approach and also testing the newer antiemetics. Because of the high incidence of postoperative nausea and vomiting as a patient-important outcome, the preventive strategies should be considered as serious condition which requires multimodal approach.

scholarly journals Comparative Efficacy of Ondansetron Versus Granisetron to Prevent Perioperative Nausea and Vomiting in Patients undergoing Gynaecological Surgery under Spinal Anaesthesia

2017 ◽  
Vol 6 (1) ◽  
pp. 1371
Author(s):  
Robina Makker ◽  
Amit Bhardwaj ◽  
Arwinder Pal Singh ◽  
Asha Anand
Keyword(s):  
Spinal Anaesthesia ◽  
Postoperative Period ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Study Groups ◽  
Early Postoperative Period ◽  
Nausea And Vomiting ◽  
Gynaecological Surgery ◽  
Significant Difference ◽  
Late Postoperative Period

<p><strong>Background</strong>: Posotoprative nausea and vomiting remains a persistent and distressing problem inspite of many advances on perioperative care and anti-emetic drugs. A newer antiemetic drug Granisetron has not been studied in patients undergoing gynaecological surgery under spinal anaesthesia.</p><p><strong>Objective</strong>: A randomized double blind study was conducted to compare Ondansetron and Granisetron for prevention of postoperative nausea and vomiting in patients undergoing gynaecological surgery under spinal anaesthesia.</p><p><strong>Material and methods</strong>: 60 consecutive patients, age between 20-65 years, ASA grade I and II undergoing gynaeacologicla surgery under spinal anaesthesia were randomized into two goups of 30 each. One group received intravenous Ondansetron 4.0 mg and the second received intravenous Granisetron 2.0 mg 5 minutes before induction of anaesthesia. For the first 24 hours postoperatively all episodes of nausea and vomiting were recorded. A complete response to the drug was considered if there was no nausea or vomiting and no need for rescue anti-emetic. The observations were tabulated and analysed.</p><p><strong>Results</strong>: During early postoperative period (0-3 hrs) there was statistically no significant difference in the study groups. Statistically significant difference was found in the study groups in the late postoperative period (3-24 hrs).</p><p><strong>Conclusion</strong>: In the early postoperative period both Ondansetron and Granisetron are equally effective in preventing postoperative nausea and vomiting in patients undergoing gynaecological surgery under spinal anaesthesia. Granisetron is better than Ondansetron in the late postoperative period of upto 24 hrs.</p>

scholarly journals Droperidol Reduces Postoperative Nausea and Vomiting and Supports the Continuation of Intravenous Patient-Controlled Analgesia with Fentanyl

2020 ◽  
Vol 23 ◽  
pp. 220-230
Author(s):  
Ikkou Hirata ◽  
Masahiro Iwamoto ◽  
Hiroki` Matsui ◽  
Hiromi Yoshinuma ◽  
Ryohkan Funakoshi
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Postoperative Nausea ◽  
Pain Treatment ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Patient Controlled Analgesia ◽  
Secondary Endpoints ◽  
The Impact

PURPOSE: To examine the impact of adding droperidol to fentanyl-based intravenous patient-controlled analgesia (IVPCA) on the discontinuation of IVPCA use due to postoperative nausea and vomiting (PONV). METHODS: Patients who underwent surgeries other than abdominal surgeries and used IVPCA between April 2014 and March 2018 were selected. Patients using IVPCA with fentanyl alone were compared to patients using droperidol added to IVPCA. Patients were allocated to one of two groups depending on the drug used for IVPCA: 1) control group, fentanyl alone; 2) droperidol group, droperidol with fentanyl. The primary endpoint was the discontinuation of IVPCA due to PONV. Secondary endpoints included PONV within 48 hours after surgery, the number of antiemetics used, pain score, and adverse effects. Propensity score matching was used to control the differences in clinical features among patients. RESULTS: Among the 793 patients initially enrolled in this study, 145 were excluded via propensity score matching; 364 of the remaining patients received IVPCA supplemented with droperidol. Propensity score matching showed that discontinuation of IVPCA due to PONV was significantly decreased in the droperidol group compared to the control group (P = 0.01). Further, compared with the control group, the droperidol group had reduced nausea up to 24 hours after surgery (P < 0.01), and the number of vomiting episodes and use of antiemetics decreased within 12 hours after surgery (P < 0.01). CONCLUSIONS: The addition of droperidol to IVPCA is associated with a decrease in PONV, as well as the improved continuation of pain treatment with fentanyl-based IVPCA, similar to IVPCA with morphine. However, it is necessary to monitor the side effects of this treatment.

scholarly journals The influence of dexamethasone and ketolgan on postoperative nausea and vomiting and estimation of risk factors in women undergoing gynecologic laparoscopic surgeries

Medicina ◽  
2010 ◽  
Vol 46 (4) ◽  
pp. 261 ◽  
Author(s):  
Kęstutis Rimaitis ◽  
Asta Svitojūtė ◽  
Andrius Macas
Keyword(s):  
Risk Factors ◽  
Postoperative Analgesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Double Blind ◽  
Randomized Clinical Study ◽  
Dexamethasone Group ◽  
And Control

The aim of this study was to determine the effect of dexamethasone and ketolgan on postoperative nausea and vomiting and to evaluate risk factors for postoperative nausea and vomiting. Material and methods. A prospective, double-blind, randomized clinical study was carried out. One hundred fi fty-three ASA I–II women undergoing laparoscopic gynecologic operations were randomized into three groups: dexamethasone group (n=51), ketolgan group (n=51), and control group (n=51). Patients in the dexamethasone group were given 4 mg of dexamethasone intravenously before the induction of general anesthesia, the ketolgan group received 30-mg ketolgan intravenously, and control group did not receive any medication. The incidence and severity of postoperative nausea and vomiting were registered 24 hours after the surgery. Results. The incidence of postoperative nausea and vomiting in the dexamethasone group was 13.8%; in the ketolgan group, 37.3%, and in the control group, 58.9% (P=0.026). Patients with a history of migraine suffered from postoperative nausea and vomiting in 70.3% of cases and migraine- free patients in 25.8% of cases (P=0.015). Opioids for postoperative analgesia increased the incidence of postoperative nausea and vomiting as compared with nonsteroidal anti-infl ammatory drugs (P=0.00002). Conclusions. Preoperative medication with dexamethasone signifi cantly reduces the incidence of postoperative nausea and vomiting. Avoidance of opioids for postoperative analgesia reduces the incidence of postoperative nausea and vomiting. Migraine and motion sickness are independent risk factors for postoperative nausea and vomiting.

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

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

Pterygopalatine Fossa Block as a Component of Multimodal Anesthesia in an Ophthalmic Surgery

2020 ◽  
pp. 6-14
Author(s):  
V Serdiuk ◽  
N Mynka ◽  
Yu Kobelyatsky
Keyword(s):  
Postoperative Nausea ◽  
Carbon Dioxide Concentration ◽  
Postoperative Nausea And Vomiting ◽  
Pterygopalatine Fossa ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Ophthalmic Surgery ◽  
Non Invasive ◽  
Exhaled Air

Materials and methods. The study included 20 patients aged 25 to 84, 11 men and 9 women with various front eye pathologies. 10 patients were anesthetized according to the classic scheme taken in our clinic. In the other 10 patients, the pain relief scheme was supplemented by the implementation of pterygopalatine fossa block. Monitoring during the operation included non-invasive monitoring of hemodynamics, pulsoxymetry, determination of oxygen and carbon dioxide concentration in exhaled air. In postoperative period level of pain was fixed using visual-analogue scale and frequency of postoperative nausea and vomiting. Results. The study found that patients in the groups had no statistically significant differences in sex, age and severity of surgery. At all stages of the study, the severity of pain in patients with the pterygopalatine fossa block was reliably lower than in patients in the control group. The incidence of postoperative nausea and vomiting was also lower in the blockade group.

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