scholarly journals Comparison of the Effects of Sugammadex, Neostigmine, and Pyridostigmine on Postoperative Nausea and Vomiting: A Propensity Matched Study of Five Hospitals

2020 ◽  
Vol 9 (11) ◽  
pp. 3477
Author(s):  
Jong Ho Kim ◽  
Man-Sup Lim ◽  
Jun Woo Choi ◽  
Haewon Kim ◽  
Young-Suk Kwon ◽  
...  
Keyword(s):  
Propensity Score ◽  
Confidence Interval ◽  
General Anesthesia ◽  
Propensity Score Matching ◽  
Postoperative Nausea ◽  
Odds Ratio ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Patient Groups ◽  
Matched Study

Thus far, few studies have compared the effects of sugammadex and cholinesterase inhibitors on postoperative nausea and vomiting (PONV), and the results have been controversial. Here, we compared the effects of sugammadex, neostigmine, and pyridostigmine on PONV by means of a five hospital analysis with propensity score matching. We analyzed adults aged ≥ 18 years who underwent general anesthesia between January 2014 and December 2019. Following propensity score matching, 7793 patients were included in each of the neostigmine and sugammadex matched patient groups (absolute standardized difference (ASD), 0.01–0.07), and 10,197 patients were included in each of the pyridostigmine and sugammadex matched patient groups (ASD, 0.01–0.02), while 19,377 patients were included in each of the pyridostigmine and neostigmine matched patient groups. (ASD, 0.01–0.19). The odds of PONV were low in the sugammadex group (odds ratio, 0.65; 95% confidence interval, 0.59–0.72; p < 0.0001) and pyridostigmine group (odds ratio, 0.22; 95% confidence interval, 0.20–0.24; p < 0.0001) compared to the neostigmine group, while there was no difference between sugammadex and pyridostigmine (odds ratio, 0.95; 95% confidence interval, 0.86–1.04; p = 0.281). Therefore, sugammadex and pyridostigmine may lower the incidence of PONV compared to neostigmine in patients undergoing general anesthesia.

scholarly journals Comparison of Postoperative Events between Spinal Anesthesia and General Anesthesia in Laparoscopic Cholecystectomy: A Systemic Review and Meta-Analysis of Randomized Controlled Trials

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Xian-Xue Wang ◽  
Quan Zhou ◽  
Dao-Bo Pan ◽  
Hui-Wei Deng ◽  
Ai-Guo Zhou ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Confidence Interval ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Postoperative Nausea ◽  
Meta Analysis ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Urine Retention ◽  
Anesthesia Group

Background. Laparoscopic cholecystectomy is usually carried out under general anesthesia. There were a few studies which have found spinal anesthesia as a safe alternative. We aimed to evaluate the postoperative events between spinal anesthesia and general anesthesia in patients undergoing laparoscopic cholecystectomy.Methods. We searched PubMed, Embase, and Cochrane Library (from inception to January 2016) for eligible studies. The primary outcome was the visual analogue scale score. Secondary outcomes included postoperative nausea and vomiting and urine retention 24 hours postoperatively. We calculated pooled risk ratios and 95% confidence interval using random- or fixed-effects models.Results. Eight trials involving 723 patients were listed. Meta-analysis showed that patients in spinal anesthesia groups have lower visual analogue scale score 24 hours postoperatively. There were significant decreases in the occurrence of postoperative nausea and vomiting in spinal anesthesia group when compared with general anesthesia group (odds ratios: 0.38, 95% confidence interval: 0.19–0.76;P=0.006) with heterogeneity accepted (I2=13%;P=0.33), while urine retention rate was increased in patients with spinal anesthesia (odds ratios: 4.95, 95% confidence interval: 1.24–19.71;P=0.02) without any heterogeneity (I2=0%;P=0.98).Conclusions. Spinal anesthesia may be associated with less postoperative pain and postoperative nausea and vomiting compared with general anesthesia.

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 A Single Perioperative Injection of Dexamethasone Decreases Nausea, Vomiting, and Pain after Laparoscopic Donor Nephrectomy

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Shigeyoshi Yamanaga ◽  
Andrew Mark Posselt ◽  
Chris Earl Freise ◽  
Takaaki Kobayashi ◽  
Mehdi Tavakol ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Donor Nephrectomy ◽  
Nausea And Vomiting ◽  
Complication Rates ◽  
Opioid Use ◽  
Laparoscopic Donor Nephrectomy ◽  
Before And After

Background. A single dose of perioperative dexamethasone (8–10 mg) reportedly decreases postoperative nausea, vomiting, and pain but has not been widely used in laparoscopic donor nephrectomy (LDN). Methods. We performed a retrospective cohort study of living donors who underwent LDN between 2013 and 2015. Donors who received a lower dose (4–6 mg)  (n=70) or a higher dose (8–14 mg) of dexamethasone (n=100) were compared with 111 donors who did not receive dexamethasone (control). Outcomes and incidence of postoperative nausea, vomiting, and pain within 24 h after LDN were compared before and after propensity-score matching. Results. The higher dose of dexamethasone reduced postoperative nausea and vomiting incidences by 28% (P=0.010) compared to control, but the lower dose did not. Total opioid use was 29% lower in donors who received the higher dose than in control (P=0.004). The higher dose was identified as an independent factor for preventing postoperative nausea and vomiting. Postoperative complication rates and hospital stays did not differ between the groups. After propensity-score matching, the results were the same as for the unmatched analysis. Conclusion. A single perioperative injection of 8–14 mg dexamethasone decreases antiemetic and narcotic requirements in the first 24 h, with no increase in surgical complications.

scholarly journals Effect of Body Mass Index on Postoperative Nausea and Vomiting: Propensity Analysis

2020 ◽  
Vol 9 (6) ◽  
pp. 1612 ◽  
Author(s):  
Jong Ho Kim ◽  
Mingi Hong ◽  
Young Joon Kim ◽  
Ho Seok Lee ◽  
Young Suk Kwon ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Body Mass ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Obese Patients ◽  
Underweight Patients ◽  
The Impact

The impact of body mass index (BMI) on postoperative nausea and vomiting (PONV) is controversial, and few studies have focused on their relationship. We investigated the effects of BMI on PONV, taking into account other PONV risk factors. We analyzed adults over the age of 18 years who received general anesthesia between 2015 and 2019, using propensity score matching. Before propensity score matching, odds ratios (ORs) for PONV were lower for overweight (OR, 0.91; 95% confidence interval (CI), 0.87–0.96; p < 0.0001) or obese patients (OR, 0.77; 95% CI, 0.71–0.84; p < 0.0001) than for normal-BMI patients. After matching, the ORs for PONV of overweight (OR, 0.89; 95% CI, 0.80–0.98; p = 0.016) and obese patients (OR, 0.71; 95% CI, 0.63–0.79; p < 0.0001) were low. However, the ORs of underweight patients did not differ from those of normal-BMI patients, irrespective of matching. Therefore, the incidence of PONV may be lower among adults with a higher-than-normal BMI.

scholarly journals Comparison of the Efficacy of Metoclopramide Versus Dexamethasone for the Prevention of Postoperative Nausea Vomiting during General Anesthesia

2021 ◽  
pp. 163-168
Author(s):  
Sunil Arjan ◽  
Naila Zahoor ◽  
Kenza Nadeem ◽  
Farah Liaquat ◽  
Tariq Hussain Mughal ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Female Ratio ◽  
Post Operative Nausea ◽  
Group D ◽  
Male To Female

Objective:To evaluate the efficacy of Metoclopramide versus Dexamethasone for prevention of postoperative nausea and vomiting during general anesthesia. Study Design:This is a Randomized control trial (RCT) study. Setting: Study carried out at Department of Anaesthesiology, Surgical Intensive Care Unit and Pain Management, Clinic, Dow University of Health Sciences and  Dr. Ruth Pfau  Hospital Karachi, from December 2018 to June 2019. Materials and Methods:110 patients undergoing elective surgeries, who fulfilled the inclusion criteria and gave informed consent were included in the study. They were randomly assigned to either group M or group D, with 55 patients in each group. All patients were then administered either intravenous dexamethasone (8mg) in group D or intravenous metoclopramide (10mg) in group M at the time of induction of anesthesia. The main outcome measure was postoperative nausea and vomiting, at the end of 6th hour postoperatively. The SPSS version 21 was applied to the data. Results: Majority of the patients 66 (60%) were of age 35 years or less. Mean age of the patients was 35.09±11.55 years. There were more females than males, with male to female ratio being 1:1.03. Overall, in patients receiving metoclopramide, 12(21.8%)  had postoperative nausea and vomiting, while in patients who received dexamethasone, only 4 (7.3%) patients had post-operative nausea and vomiting. When comparing two groups, there was statistically significant (p= 0.02) reduced postoperative nausea/vomiting among those patients who had received intravenous dexamethasone. Conclusion: Intravenous dexamethasone is more effective than Metoclopramide in preventing postoperative nausea and vomiting in patients during general anesthesia.

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

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