scholarly journals POSTOPERATIVE NAUSEA AND VOMITING (PONV)

2010 ◽  
Vol 17 (03) ◽  
pp. 394-399
Author(s):  
ZULFIQAR ALI ◽  
TANVEER AHMAD ◽  
IRSHAD AHMAD ◽  
A G Rehan

Objective: To evaluate the effect of preoperative single dose injection dexamethasone for prevention of PONV in patients undergoing laparoscopic cholecystectomy and comparing it with normal saline (placebo). Design: Experimental RCT study. Place and duration of study: The study was conducted at Madina Teaching hospital, University Medical & Dental College, Faisalabad from January, 2008 to October 2009. Materials and Methods: After approval from the hospital ethical committee, 200 patients with ASA I & II were included in the study. We divided the patients into two groups; group I received preoperative dexamethasone (8mg) and the group II received normal saline (placebo) 90 minutes before the surgery. Patients were observed for any episodes of nausea or vomiting, need for rescue antiemetics, and complete responses in the postoperative period. The complete response was defined as no nausea, no vomiting, and no ant emetic medicationduring a 24-h postoperative period. This was also the primary efficacy end point of the study. The data was analyzed using Pearson’s Chi square test with P < 0.05 taken as significant. Results: Nineteen patients (19%) in the dexamethasone group reported nausea, compared with 43 (43%) in placebo group (p<0.05). Eight patients (8%) in the dexamethasone group reported vomiting and twenty two patients (22%) in theplacebo group reported vomiting (P <0.05). In group I, thirteen patients (13%) asked for rescue anti-emetic where as in group II (placebo group) thirty six patients (36%) asked for rescue anti-emetic (p<0.05). Seventy three patients (73%) in the dexamethasone group showed a complete response, compared with 35 (35%) in placebo group (p<0.05). Conclusion: We concluded that preoperative dexamethasone (8mg) reducesthe incidence of PONV as compared to placebo. As it is a cheap, freely available drug causing no complications, it should be used in otherwise fit selected patients undergoing laparoscopic cholecystctomy.

2021 ◽  
Vol 15 (6) ◽  
pp. 1227-1229
Author(s):  
R. Farooqi ◽  
T. Iqbal ◽  
M. S. Mehmood ◽  
Z. Y. Bhatti ◽  
F. Liaquat

Aim: To Compare frequency of sore throat in early post operative period among patients undergoing general anaesthesia and endotracheal intubation for abdominal surgeries who are given dexamethasone and normal saline. Study Design: Randomized controlled study Setting: Department of Anesthesia/ ICU, Sheikh Zayed Hospital, Lahore Duration of study: Six months i.e. 25-09-2009 to 25-03-2010. Methodology: 120 patients undergoing elective general surgery on abdomen were selected. They were divided into two groups. Group I received dexamethasone 8mg (2ml) I/V pre-operatively and group II received 2ml normal saline I/V pre-operatively. Chi square test was used. Visual analogue (VAS) scale was used for recording sore throat. The VAS score ≤4 was considered as no sore throat and VAS scores>4 were considered as the sore throat. Results: Frequency of post-operative sore throat after the first 24 hours following GA and endotracheal intubation was lower in group (I) as compared to the control group (II). Eleven (20%) patients with dexamethasone had post-operative sore throat compared to thirty one (56.3%) patients in control group. (p<0.01). Conclusion: Pre-operative use of dexamethasone was associated with decreased incidence of post-operative sore throat. Keywords: Visual analogue scale (VAS), Post-operative sore throat, general anesthesia


2021 ◽  
Vol 14 (1) ◽  
pp. 151-155
Author(s):  
M.I. Kogan ◽  
◽  
A.G. Makarov ◽  
V.V. Sizonov ◽  
I.M. Kagantsov ◽  
...  

Introduction. Transscrotal orchiopexy is gradually gaining more and more adherents and expanding the boundaries of its use. At the stage of funiculolysis, the use of the transscrotal approach is accompanied by extensive dissection of the tunica dartos, which makes it almost impossible to use the Shoemaker technique for testicular fixation. The described situation determines the need to develop a testicular fixation technique with transscrotal approach (TA). Material and methods. The study included 186 patients operated on for unilateral inguinal cryptorchidism in the period from 2009 to 2019 using TA Left-sided cryptorchidism was in 76 (41%), right-sided in 110 (59%) boys. Group I – 89 (47.8%) patients operated on TA according to the Bianchi technique, the average age of patients was 45.9 ± 39.6 months. Group II – 97 (52.2%) patients, mean age 47.8 ± 41.6 months, operated on TA using an original method of testicular fixation, consisting in the formation of a cuff from subcutaneous adipose tissue around the spermatic cord by suturing it from superficial inguinal ring, above and below the spermatic cord in the caudal direction to the entrance to the scrotum. In the postoperative period, the volume and position of the gonads in the scrotum were assessed at 3, 6 and 12 months after surgery. To determine the significance of differences between the groups, Student's t-test and chi-square test were used. Results. Unsatisfactory position of the gonads in the postoperative period in group I was noted in 6 (9.5 %), in group II in 1 (1.16%) cases (p < 0.05). Testicular atrophy was detected in group I in 1 (1.59%) patient, in group II also in 1 (1.16%) patient (p> 0.05). The testicular hypotrophy index decreased after 12 months. In group I from 60.7 ± 21.2% to 44.3 ± 23.9%, in group II from 63.1 ± 19.4% to 43.8 ± 19.1%, (p < 0.05). Conclusions. The author's testicular fixation technique for transscrotal orchiopexy provides the safety of surgery comparable to the standard Bianchi and Squire technique, but higher efficiency in preventing testicular malposition after surgery.


2011 ◽  
Vol 52 (1/3) ◽  
pp. 45-47
Author(s):  
Carolina Dos Santos Guimarães ◽  
Gerhilde Callou Sampaio ◽  
Élvia Barros de Almeida ◽  
Luciano Barreto Silva ◽  
Ana Paula Mourato ◽  
...  

Introduction: The present study sought to assess the effect of apical foramen cleaning in the repair of periapical lesions detected by radiography. Methods: The sample comprised 980 teeth collected from 25 February 1997 to 15 March 2005 which had been subjected to endodontic treatment and exhibited radiographically visible periapical lesions. The sample was then divided into two groups: Group I, 402 root canal treatments in which cleaning of the apical foramen had not been performed, and Group II, composed of the remaining 578 root canal treatments where the procedure had been performed. After one year, the teeth were clinically and radiographically evaluated. Results: In Group I, 360 canals (89.55%) had no evidence of periapical lesions, versus 521 (90.13%) in Group II. Partial presence of these lesions was observed in 23 canals (5.72%) in Group I versus 27 (4.67%) in Group II. No changes in images were observed in 19 (4.72%) canals in Group I and 30 in Group II. Pearson’s chi-square test showed no statistically significant difference between the Groups I and II (p = 0.732). Conclusions: These findings suggest that foramen cleaning is not a determinant of periapical lesion repair.


2021 ◽  
Vol 15 (11) ◽  
pp. 3116-3118
Author(s):  
Gulsher . ◽  
Riffat Zahid ◽  
Syed Mehmood Ali ◽  
Muhammad Naveed Shahzad ◽  
Amer Latif ◽  
...  

Objective: To compare the frequency of post dural puncture headache with Quincke 25G and Quincke 27G of spinal needles for spinal anesthesia. Design of the Study: It’s a Randomized control trial. Study Settings: This study was carried out Department of anesthesiology and Intensive Care Unit, Shaikh Zayed Hospital Lahore from 29-08-2020 to 01-03-2021. Material and Methods: In this prospective study 100 patients were enrolled who were decided to undergo spinal anesthesia. Two groups were made by randomization. In patients of group I, anesthesia was administered by using 25G quincke needle while 27G quincke needle was used for patients in group II. Evaluation of patients was with regard to development of postoperative PDPH within 3-days. Groups were compared by using Chi-square test and a P-value<0.05 was taken statistically significant. Results of the Study: PDHD was seen in 14 (28%) patients in group I and in 4 (8%) patients in group II. Statistically, the difference between the two groups was significant (p<0.05).. Conclusion: Due to less frequency of PDPH with 27G needle, it should be given preference for applying spinal anesthesia over 25G needle. Keywords: Spinal anesthesia, post dural puncture headache; quincle needle.


2019 ◽  
Vol 6 (3) ◽  
pp. 833
Author(s):  
Shahnaz Ahmad Sheikh ◽  
Aabid Hussain Mir ◽  
Abida Yousuf ◽  
Imtiaz Ahmad Naqash

Background: Endotracheal intubation is associated with postoperative sore throat. The aim was to evaluate the efficacy of intravenous magnesium sulphate versus dexamethasone for prevention of postoperative sore throat in patients undergoing lumbar surgery in prone position.Methods: 150 patients of ASA physical status I and II in the age group of 18 to 70 years were divided into three groups of 50 each. group I (magnesium sulphate) received intravenous magnesium sulphate 30 mg. kg-1 in a total of 50 ml of normal saline for 10 minutes after intubation, group II (dexamethasone group) received intravenous dexamethasone 8 mg in 50 mL normal saline for 10 minutes after intubation and group III (placebo group) received 50 ml of normal saline for 10 minutes after intubation. The incidence and severity of postoperative sore throat and hoarseness was assessed by an anesthesiologist unaware of the group allocation, on arrival in the post anesthesia care unit at 0 h, and at 1 h, 6 h, 12 h, and 24 h thereafter.Results: Both incidence and severity of sore throat and incidence of hoarseness was more in placebo group than magnesium sulphate group and dexamethasone group and was statistically significant (p<0.05) and was comparable between magnesium sulphate and dexamethasone groups.Conclusions: Endotracheal intubation is associated with sore throat and hoarseness of voice. Magnesium sulphate and dexamethasone given intravenously reduce the incidence and severity of sore throat and hoarseness associated with endotracheal intubation.


1979 ◽  
Vol 9 (3) ◽  
pp. 373-378
Author(s):  
C J Helphingstine ◽  
D J Hentges ◽  
B J Campbell ◽  
J Butt ◽  
J T Barrett

Heat-extracted antigens from seven species of Bacteroides were used in passive hemagglutination and counterimmunoelectrophoretic tests. Sera from 87 normal persons (group I) and 15 patients with ulcerative colitis (group II) were of low and equal reactivity in passive hemagglutination tests; all positive tests were eliminated by 2-mercaptoethanol reduction of the sera. When these same sera were tested by counterimmunoelectrophoresis with six of the Bacteroides antigens, no significant difference in the percentage of positive reactions was noted. However, using the chi-square test, the seventh antigen, prepared from Bacteroides vulgatus, successfully distinguished the two populations at the 0.025 level. Counterimmunoelectrophoretic tests with the B. vulgatus antigen also provided a means to separate the patients in group II with active disease from those in remission at a P value of 0.01. All the sera from 12 patients with defined Crohn's disease activity indexes reacted with the B. vulgatus antigen in counterimmunoelectrophoretic tests. Reduction and alkylation of patient sera with 2-mercaptoethanol and iodoacetamide removed detectable antibody in 78% of the samples, which suggested a dominant role of immunoglobulin M in the response to Bacteroides antigens.


2008 ◽  
Vol 32 (4) ◽  
pp. 295-298 ◽  
Author(s):  
S Crespo ◽  
O Cortes ◽  
C Garcia ◽  
L Perez

The aim of this study was to compare the efficiency in both, preparation time and root canal shape, when using the Nickel Titanium (Ni-Ti) rotary and K-Files hand instrumentation on root canal preparation of single rooted primary teeth. Material and methods: Sixty single rooted primary teeth were selected and divided into two equal groups: Group (I) 30 teeth instrumented with manual K- files and group (II) 30 teeth instrumented with Ni-Ti rotary files (ProFile 0.04). Instrumentation times were calculated and root canal impressions were taken with light bodied silicone in order to evaluate the shape. The data was analyzed with SPSS program using the t-test and the Chi-square test to compare their means. Results: The preparation time with group (I) K- files was significantly higher than in group (II) rotary files (ProFile 0.04), with a p= .005. The ProFile system showed a significantly more favorable canal taper when compared to the K-files system (P= .002). Conclusions: The use of rotary files in primary teeth has several advantages when compared with manual K files: the efficiency in both, preparation time and root canal shape. 1. A decreased working time, that helps maintain patient cooperation by diminishing the potential for tiredness. 2. The shape of the root canal is more conical, favoring a higher quality of the root canal filling, and increasing clinical success.


2020 ◽  
Vol 8 (1) ◽  
pp. 64-70
Author(s):  
Ashwin Joginipally ◽  
Nikhil Mudgalkar

The occurrence of postoperative nausea and vomiting is generally associated with anesthesia and surgery. The problem is compounded in cases of high-risk surgeries where the incidence is quite high. The present study was designed to compare the efficacy of Dexamethasone and Ondansetron. Methods: This study was undertaken at the Prathima Institute of Medical Sciences, Naganoor, Karimnagar. In this randomized, open clinical trial, we studied 80 ASA grades I to 1V patients of age group 20-60 years undergoing Laparoscopic Laparotomy, Major Gynecological surgeries, Renal, Shoulder and ENT surgeries under general anesthesia. The patients were randomly divided into two groups, Group I and Group II, each consisting of 80 patients. Group I received 4mg dexamethasone intravenous (IV) just after intubation and group II received 4mg Ondansetron intravenous (IV), just before extubation. Results: The most common age group was 50 – 59 years which had n=45(28.1%) patients out of which group I was n=24(15%) patients and n=21(13.1%) patients. The next common age group was 20 – 29 years out of which n=23 (14.4%) and n=18(11.2%). ondansetron group, early nausea is mild in 6.9%, moderate in 3.8%, and severe in 1.2% of patients. Whereas in the dexamethasone group early nausea is mild in 6.2%, moderate in 4.4%, severe in 1.9% of patients. In the ondansetron group, late nausea is mild in 9.4%, moderate in 3.8%, and severe in 0.6% of patients. Whereas in the dexamethasone group late nausea is mild in 7.5%, moderate in 4.4%, severe in 0.6% of patients. In the ondansetron group, early vomiting is mild in 5.0%, moderate in 0.6%, and severe in 0.6% of patients. Whereas in the dexamethasone group early vomiting is mild in 4.4%, moderate in 1.2%, severe in 0.6% of patients. Conclusion: dexamethasone given intravenously just after intubation and ondansetron given intravenously just before extubation are safe and have similar efficacy in postoperative nausea and vomiting after elective surgeries under general anesthesia having a high risk of PONV


2015 ◽  
Vol 9 (1) ◽  
pp. 3-6
Author(s):  
Lipika Sanjowal ◽  
Swapan Kumar Biswas ◽  
Jitesh Chandra Saha

Postoperative nausea and vomiting (PONV) is common after anaesthesia and surgery. In patients undergoing laparoscopic cholecystectomy (LC) without antiemetic prophylaxis, the incidence can be as high as 76% which would cause unexpected delay in hospital discharge. This study was designed to compare the efficacy of the ondansetron alone with combination of ondansetron and dexamethasone the given as prophylaxis for PONV in patients undergoing laparoscopic cholecystectomy. One hundred patients undergoing elective laparoscopic cholecystectomy were selected and randomly divided into 2 groups of 50 each. Group I received 4mg of ondansetron intravenously (iv), whereas Group II received ondansetron 4mg and dexamethasone 4mg just before induction of anaesthesia. Postoperatively, the patients were assessed for episodes of nausea, vomiting and need for rescue antiemetic. Complete response defined as no nausea and vomiting during first 24 hours, was noted in 76% of patients in Group I and in 92% of patients in Group II. Rescue anti emetic requirement was less in Group II (4%) than Group I (20%). So it can be concluded that the combination of ondansetron and dexamethasone is more effective in preventing PONV in patients undergoing laparoscopic cholecystectomy than ondansetron alone.Faridpur Med. Coll. J. 2014;9(1): 3-6


1979 ◽  
Author(s):  
T.H. Schöndorf ◽  
U. Weber

162 elective hip operation patients were randomly allocated to: Group I: 5 000 U heparin injected s.c. 10 and 2 hours pre-operatively, then 8 hourly; Group II: heparin as above plus dextran 40 on three days; Group III: heparin as in group I combined with dihydroergotamine (DHE). The 125-I-fibrinogen test was routinely used for diagnosis of deep vein thrombosis (DVT), when positive, phlebography was performed. DVT occurred in 8/55 patients in group I, in 9/54 in group II and in 2/53 in group III. (Chi-square test: I vs. III p = 0.054; II vs. III p = 0.028) . Pulmonary embolism (confirmed at autopsy) occurred in one patient in both group I and II.In the three groups, the intra-operative transfusions, wound blood loss at the pre- and post-operative haematocrit did not differ.Platelet aggregation was only significantly lowered in group II.Heparin/DHE were most effective in preventing thromboemboli, dextran infusions did not improve heparin prophylaxis.Peridural anaesthesia performed in 83 - 87% of patients in all groups led to no complications following pre-operative heparin.


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