scholarly journals Comparison of aprepitant and dexamethasone versus metoclorpramide and dexamethasone for prevention of post-operative nausea and vomiting in patients undergoing laparoscopic cholecystectomy.

2021 ◽  
Vol 29 (01) ◽  
pp. 7-12
Author(s):  
Zerwah Muhammad Qayum ◽  
Aftab Hussain ◽  
Muhammad Akram ◽  
Muhammad Asif Saleem ◽  
Rehana Feroze ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Nausea And Vomiting ◽  
P Value ◽  
Significant Difference ◽  
Group A ◽  
Prospective Comparative Study ◽  
Elective Laparoscopic Cholecystectomy ◽  
Post Operative Nausea ◽  
Age Range ◽  
Study Setting

Objective: To compare the efficacy of aprepitant and dexamethasone versus metoclopramide and dexamethasone combination in prevention of post-operative nausea and vomiting in females undergoing laparoscopic cholecystectomy. Study Design: Prospective Comparative study. Setting: Department of Anesthesia, CMH Lahore. Period: October 2019 to April 2020. Material & Methods: A total of 140 female patients planned for laparoscopic cholecystectomy under general anesthesia, of age ranges from 35-65 years and ASA classification I and II were recruited for the study and were divided into two equal groups. In group A (n=70), patients were given oral aprepitant 80 mg with once sip of water one hour prior to induction and dexamethasone 8 mg upon induction. In group M (n=70), patients were given a placebo one hour prior to induction and intravenous metoclopramide 10 mg and dexamethasone 8 mg upon induction. Results: Age range in this study was from 37 to 65 years with mean age of 46.82 ± 7.29 years. The mean age of patients in group A was 45.73 ± 6.77 years and in group M was 47.91 ± 7.66 years with p-value of 0.076. In our study, significant difference was found between the efficacy of two groups of drugs. The efficacy of aprepitant and dexamethasone was found in 62 (88.57%) patients, while with metoclopramide and dexamethasone, it was found in 51 (72.86%) patients with p-value of 0.031. Conclusion: it is concluded that aprepitant and dexamethasone combination has higher efficacy as compared to metoclorpromide and dexamethasone in prevention of post-operative nausea and vomiting in elective laparoscopic cholecystectomy.

scholarly journals Comparison of Propofol Vs Thiopentone in Post Operative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy

2019 ◽  
Vol 18 (1) ◽  
pp. 23-29
Author(s):  
Bhuwan Raj Kunwar ◽  
Thaneshowr Rijal ◽  
Puja Thapa ◽  
Mallika Rayamajhi ◽  
Biswo Ram Amatya
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Statistical Significance ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
P Value ◽  
Fisher Exact Test ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Post Operative Nausea

Introduction: Postoperative Nausea and Vomiting (PONV) is one of the commonest causes of significant morbidity in the patients after laparoscopic cholecystectomy. The purpose of this study was to compare the incidence of PONV when propofol and thiopentone were used as induction agents during laparoscopic cholecystectomy. Methods: A prospective, randomised comparative study was conducted in operation theatre at a tertiary level referral hospital of Nepal. A sample size of 100 ASA I - II patients aged between 18 and 70 years were included and scheduled for elective laparoscopic cholecystectomy. The study population were divided into two groups: Group A (Propofol), n = 50 and Group B (Thiopentone), n = 50. These patients were followed up for the first 24 hours postoperatively for any PONV at 0-6 hrs, 6-12 hrs, 12-24 hrs. Results: Out of the 100 patients, PONV was observed almost similar in both groups. i.e. group A (Propofol) n = 31, (62%) and group B (Thiopentone) n = 26 (52%) with no statistical significance (p value = 0.1998) within the first 24 hours postoperatively in both groups; and no significant difference was observed at the different time intervals viz. at 0-6 hrs (p value 0.262): Group A = 45%; Group B = 40%; 6-12 hrs (p value 0.781): Group A = 17.5%, Group B = 22.5%; 12-24 hrs (p value 1.000) Group A = 0%; Group B = 2.5% when using the Fisher exact test. The mean ages for development of PONV in these two groups were: Group A = 40 years and Group B = 38 years. The p-value was 0.5125 which showed no statistical significance. In our study 76% (n = 38) were females and 24% (n = 12) were males in Group A; while 70% (n = 35) were females and 30% (n = 15) males in Group B. However, there was no statistical difference between the two groups in terms of PONV. Conclusions: The study showed that there was a high incidence of PONV during laparoscopic cholecystectomy. However, there was no significant difference in the incidence of PONV when propofol or thiopentone was used.  

scholarly journals Granisetron Versus Ondansetron for Prevention of Post-operative Nausea and Vomiting (PONV) in Patients Undergoing Laparoscopic Cholecystectomy

2021 ◽  
pp. 11-17
Author(s):  
Muhammad Naeem ◽  
Rafia Tabassum ◽  
Muhammad Saleh Khaskheli ◽  
Aijaz Hussain Awan ◽  
Munazzah Meraj ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Single Dose ◽  
Nausea And Vomiting ◽  
P Value ◽  
Significant Difference ◽  
Ethical Approval ◽  
Elective Laparoscopic Cholecystectomy ◽  
Post Operative Nausea

Aim: To determine the efficacy of single dose Granisetron versus ondansetron in preventing PONV in patients undergoing elective laparoscopic cholecystectomy. Methodology: A total of 100 patients were included in this study after the ethical approval of PUMHSW. Patients were randomly divided into two groups, in (Group G) 50 patients were given Granisetron and in (group O) 50 patients were given Ondansetron.  Every patient was evaluated for PONV at one hour, two hours, three hours, six hours, twelve hours and 24 hours post operatively. Results: A sample of 100 patients with age between 20-60 years (mean age 43.72±5.67 years), were included in this study. Patients were received granisetron 1 mg I/V and other patients received ondansetron 4mg I/V before induction. Conclusion: we concluded that there was no significant difference between efficacy of granisetron and ondansetron as the p-value is found to be ≤0.05.

Comparison of effect of Various Combinations of four drugs i.e IV Ondansetron, Ranitidine, Metoclopramide and Omeprazole, to reduce Gastric Fluid Residual Volume and Gastric Acidity in Elective Laparoscopic-Cholecystectomy patients

2021 ◽  
Vol 15 (7) ◽  
pp. 1760-1763
Author(s):  
Riffat Saeed ◽  
Irfan Ali ◽  
Iram Qamar ◽  
Syed Mehmood Ali ◽  
Amer Latif ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gastric Acidity ◽  
Gastric Fluid ◽  
P Value ◽  
Residual Volume ◽  
Significant Difference ◽  
Group A ◽  
Elective Laparoscopic Cholecystectomy ◽  
Group B ◽  
Group D

Background: Inhaling of gastric contents in lower respiratory tract and larynx results in developing of pulmonary aspiration. The acidity of aspirate contents and its volume determines severity of aspiration and is major cause of post-anesthetic mortality. Objective: To compare the effect of four drugs (ranitidine, IV ondansetron, metoclopramide, omeprazole and metoclopramide) in all possible four combinations, to decrease gastric fluid residual volume and gastric acidity in undergoing laparoscopic-cholecystectomy. Design: It was a clinical randomized trial. Study Settings: Trial was conducted at Department of Anesthesiology and ICU, Sheikh Zayed Hospital, Lahore, for a period of 6 months from 01-07-2019 to 31-12-2019. Patients and Methods: A total of 308 patients from both the genders undergoing laparoscopic cholecystectomy were included in this study. Four equal groups were made by random division of patients. Group A: ranitidine & ondansetron, group B: ranitidine & metoclopramide, group C: omeprazole & ondansetron and group D: omeprazole & metoclopramide. Pre-anesthetic medicine was given to all the patients two hours before surgery. For assessing volume of gastric fluid and its pH, an oro-gastric tube was passed. An informed written informed consent was taken from all the patients. Results: Mean age in this study was 36.40±9.15, 33.23±9.13, 36.82±9.37 and 36.57±9.49 years respectively for Group A,B,C and D. Aspirate had mean quantity of 12.56±5.60 ml/kg, 12.65±5.39 ml / kg, 13.68±5.76 ml/kg and 14.34±6.85 ml/kg and he aspirate mean pH was 2.56±0.55, 2.47±0.58, 2.51±0.57 and 2.45±0.58 respectively for group A,B,C and D. Among both the trial groups, this different was insignificant (p-value > 0.05) for both outcomes. Conclusion: All the drug combinations had no significant difference. However, comparatively less pH and volume of gastric fluid was shown by combination of ranitidine plus ondansetron. Therefore, this combination is recommended before general anesthesia for reducing gastric fluid aspirate in patients undergoing surgery. Keywords: Laparoscopic cholecystectomy, Omeprazole, Ranitidine, Metoclopramide, Ondansetron, gastric fluid acidity, pH, gastric fluid volume

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 ANTIBIOTIC PROPHYLAXIS IN LAPAROSCOPIC CHOLECISTECTOMY: IS IT WORTH DOING?

2016 ◽  
Vol 29 (3) ◽  
pp. 170-172 ◽  
Author(s):  
Márcio Alexandre Terra PASSOS ◽  
Pedro Eder PORTARI-FILHO
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Antibiotic Prophylaxis ◽  
Infectious Complications ◽  
Low Risk ◽  
Double Blind Study ◽  
Significant Difference ◽  
Risk Patients ◽  
Group A ◽  
Elective Laparoscopic Cholecystectomy ◽  
Group B

ABSTRACT Background: Elective laparoscopic cholecystectomy has very low risk for infectious complications, ranging the infection rate from 0.4% to 1.1%. Many surgeons still use routine antibiotic prophylaxis Aim: Evaluate the real impact of antibiotic prophylaxis in elective laparoscopic cholecystectomies in low risk patients. Method: Prospective, randomized and double-blind study. Were evaluated 100 patients that underwent elective laparoscopic cholecystectomy divided in two groups: group A (n=50), patients that received prophylaxis using intravenous Cephazolin (2 g) during anesthetic induction and group B (n=50), patients that didn't receive any antibiotic prophylaxis. The outcome evaluated were infeccious complications at surgical site. The patients were reviewed seven and 30 days after surgery. Results: There was incidence of 2% in infection complications in group A and 2% in group B. There was no statistical significant difference of infectious complications (p=0,05) between the groups. The groups were homogeneous and comparable. Conclusion: The use of the antibiotic prophylaxis in laparoscopic cholecystectomy in low risk patients doesn't provide any significant benefit in the decrease of surgical wound infection.

scholarly journals COMPARISON OF ONDANSETRON AND METOCLOPRAMIDE IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY UNDER GENERAL ANESTHESIA.

2019 ◽  
Vol 26 (07) ◽  
pp. 1197-1202
Author(s):  
Hajra Shuja ◽  
Mehmood Ali Shah ◽  
Sadaf Bokhari
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
General Anesthesia ◽  
Controlled Trial ◽  
Study Groups ◽  
P Value ◽  
Significant Difference ◽  
High Incidence ◽  
Group A ◽  
Group B ◽  
Trial Setting

Background: Laparoscopic cholecystectomy is a standard treatment for cholelithiasis. It is a safe and effective treatment in many cases. General anesthesia has a high incidence for PONV. But anti-emetic drugs can help in preventing PONV. Objectives: To compare the efficacy of ondansetron and metoclopramide in patients undergoing laparoscopic cholecystectomy under general anesthesia. Study Design: Randomized controlled trial. Setting: Department of Anaesthesia, Sheikh Zayed Hospital, Lahore. Period: 6 months i.e. from 15-2-2017 to 15-8-2017. Material & Methods: The patients were divided into two groups. Ondansetron was given to group A patients within 15 minutes of induction, and metoclopramide to group B patients within 15 minutes of induction. Then patients were shifted to the ward after surgery and followed-up for 24 hours for assessment of PONV. All the data was entered and analyzed on SPSS version 20. Results: The mean age of patients in group A was 38.40±12.07 years and in group B was 42.63±11.77 years. The efficacy achieved in 53 were from group A and 39 were from group B Statistically significant difference was found between the study groups i.e. p-value=0.003. Conclusion: Ondansetron showed significantly better efficacy than metoclopramide in preventing PONV after laparoscopic cholecystectomy under general anesthesia.

scholarly journals A Comparative Study Between Palonosetron and Granisetron to Prevent Postoperative Nausea and Vomiting after Laparoscopic Cholecystectomy

2018 ◽  
Vol 24 (2) ◽  
pp. 118-123
Author(s):  
SMA Taher ◽  
Jamil Raihan ◽  
M Abu Zahid ◽  
AK Azad ◽  
MI Alam ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
General Anaesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Economic Effects ◽  
Nausea And Vomiting ◽  
Peritoneal Closure ◽  
Elective Laparoscopic Cholecystectomy ◽  
Elective Procedure ◽  
Post Operative Nausea

Post operative nausea and vomiting is a frequent complication following general anaesthesia and surgery. There is frequently the case of great distress to patient and it is often the worst memory, uncomfortable of their hospital stay. Prolonged post operative nausea and vomiting may cause unexpected physical, metabolic, psychological and economic effects on the patients which slow down their recovery and reduce their confidence in future surgery and anaesthesia. In the present study, we have the incidence of post operative nausea and vomiting in sixty (60) patients undergoing for elective procedure under general anaesthesia. The patients were randomly divided into two groups (group- P, group- G) of thirty (30) patients each.The Patients of group ‘P’ were received intravenous Inj. Palonosetron 75μg and group ‘G’ received intravenous Inj. granisetron 2.5mg (2.5ml) bolus over 30 second just before peritoneal closure. Both group received a standard general anaesthesia. Postoperative analgesia was provided with per rectal diclofenac suppository (50mg) and Inj. Ketorolac Tromethamine 30mg 8 hourly. In the recovery, postoperative room occurrence of nausea and vomiting was assessed for 24 hours. The incidence of post operative nausea and vomiting was reduced in both groups significantly but comparison between these two groups for prevention of PONV(postoperative nausea and vomiting) following elective laparoscopic cholecystectomy surgery is similar. Palonosetron has more prolonged effect than granisetron. There was no evidence of any adverse side effects and whole of the post operative period was smooth.TAJ 2011; 24(2): 118-123

scholarly journals CHOLECYSTECTOMY;

2017 ◽  
Vol 24 (07) ◽  
pp. 1062-1066
Author(s):  
Bashir Ahmed ◽  
Hamid Raza ◽  
Kamlaish -
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Patient Population ◽  
P Value ◽  
Care Hospital ◽  
Rescue Analgesia ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Eye Opening ◽  
Group B

Objectives: The aim of our study which is to compare total intravenousanesthesia with target controlled infusion using the drugs Propofol and remifenatnil with thetechniques of volatile induction maintenance anesthesia using sevoflurane and sufentanil inpatients undergoing laparoscopic cholecystectomy procedure, at a tertiary care hospital inKarachi, Pakistan. Study Design: The type of study is a randomized control trial, conductedfor a period of 8 months Period: from June 2015 to January 2016 Setting: at a tertiary carehospital in Karachi Pakistan. Method: The patient population consisted of n=100 patientsbelonging to the ASA class I and II and undergoing laparoscopic cholecystectomy procedure atour institute. The patients were divided into two groups group A consisted of all those patientswho underwent total intravenous anesthesia and group B consisted of patients who underwentvolatile induction maintenance anesthesia. Appropriate blinding measures were taken for thosewho were involved in the post-operative care of the patients, and the patients themselves. Duringthe procedure routine monitoring was done, data was recorded in a pre-designed proforma.Patients were analyzed in the post-operative period for side effects and pain levels. Statisticalanalysis was done using SPSS version 23, a p value of less than 0.05 was considered to bestatistically significant. Results: The patient population consisted of n= 100 patients dividedinto two groups. No statistically significant difference was found between the demographicvariables of the patients of both groups (age, weight, baseline values of blood pressure, heartrate, time duration of surgery and anesthesia). The time for the loss of corneal reflex was longerin the group A (109 +/- 90) as compared to group B (45 +/- 10) having a p value of less than0.001. However the time for opening of the eyes and the duration of post anesthesia care unitwas shorter in group A (420 +/- 130 seconds for eye opening and 45 +/- 15 min for PACU) andin group B (484 +/- 116 seconds for eye opening and 53 +/- 25 mins for PACU) having p valuesof 0.006 (eye opening) and 0.017 (PACU) respectively. In group A n= 44 (88%) of the patientsrequired rescue analgesia, and in group B n= 36 (72%) of the patients required it, having a pvalue of 0.013 respectively. The need for the use of ephedrine and atropine in the pre and portoperative period was similar in both the groups. Conclusion: According to the results of ourstudy we found that each method of anesthesia has its own advantages and disadvantagesand the anesthetist present should weigh the risks and benefits for each patient individually,and use the most beneficial method of administration of anesthesia in the patient undergoinglaparoscopic cholecystectomy procedure, accordingly.

scholarly journals Correlation Between the Prostate-Specific Antigen Level and Bone Metastasis in Prostate Cancer. (Retrospective Study)

2020 ◽  
Vol 2 (2) ◽  
pp. 1-6
Author(s):  
Adel Hassan Mohamed Hassan ◽  
◽  
Tarek Huissen kamel ◽  
Nesreen Ahmed Mosalam ◽  
◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Metastasis ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
P Value ◽  
Asymptomatic Patients ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Age Range

Background: The most common non-cutaneous malignancy for men is Prostate cancer (PCa). PCa diagnosed by biopsy and PSA detection. Bone metastasis (BM) causes a lot of complications, such as bone pain and pathological fracture that cause overall compromised quality of life. Bone scintigraphy (BS) is commonly used for monitoring and detection of (BM). Objective: To correlate between serum PSA level and BM in PCa patients on series of 250 patients through detecting PSA levels and BSs. Patients and Methods: In the present study Patients were stratified (group A) & (group B) according to BM. Out of the 250 patients, 180 patients (Group A localized PCa) were with age range from 57 -92 years, the remaining 70 patients (Group B metastasis PCa) the age range was 53-88 years. Prostate specific antigen (PSA) level for both groups were detected. Results: By comparing group A and group B there was a highly significant difference in PSA value in favor of positive BS group (p-value < 0.001). The present study recommends BS in asymptomatic patients with PSA above 60 Ng/ml. Conclusion: PCa is the most common malignant non-cutaneous tumor for men. The most common spread for PCa is bone spread. Age doesn’t correlate with BM in PCa patients. PSA total show highly significance with BM in PCa patients. PSA cut-off value for BM in PCa patients was 60 Ng/ml so it was recommended to perform BS for asymptomatic patients with PSA total above 60 Ng/ml.

Sign in / Sign up

Export Citation Format

Share Document