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 Preoperative Fasting Abbreviation and its Effects on Postoperative Nausea and Vomiting Incidence in Gynecological Surgery Patients

2020 ◽  
Vol 42 (08) ◽  
pp. 468-475
Author(s):  
Gisele Vissoci Marquini ◽  
Francisco Edes da Silva Pinheiro ◽  
Alfredo Urbano da Costa Vieira ◽  
Rogério Melo da Costa Pinto ◽  
Maria Gabriela Baumgarten Kuster Uyeda ◽  
...  
Keyword(s):  
At Risk ◽  
Postoperative Nausea ◽  
Randomized Study ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Gynecological Surgery ◽  
Preoperative Fasting ◽  
Double Blind ◽  
Significant Difference

Abstract Objective To investigate the effects of preoperative fasting abbreviation with a carbohydrate and protein-enriched solution, on postoperative nausea and vomiting (PONV) incidence in gynecological surgery patients, a population naturally at risk for such unpleasant episodes. Methods The present prospective double-blind randomized study was performed at The Hospital Municipal e Maternidade Dr. Odelmo Leão Carneiro (HMMOLC, in the Portuguese acronym), in Uberlândia, state of Minas Gerais, Brazil, in partnership with the Gynecology Department of the Universidade Federal de São Paulo (UNIFESP), approved by the Human Research Ethics Committee of UNIFESP and the board of HMMOLC, and included in the Brazil Platform and in the Brazilian Clinical Trial Registry. After signing the consent form, 80 women, who were submitted to gynecological surgery in the period from January to June 2016, were randomized into 2 groups: control group (n = 42) and juice group (n = 38). They received, respectively, 200 mL of inert solution or liquid enriched with carbohydrate and protein 4 hours presurgery. The incidence, frequency and intensity of PONV were studied using the Visual Analogue Scale (VAS), with statistical analysis performed by the software IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp, Armonk, NY, USA). Results The incidence of nausea and vomiting was lower than in the literature, to this population, with 18.9% (14/74) for the control group and 10.8% (8/74) for the juice group, respectively, with no statistically significant difference between the groups. Conclusion The incidence of nausea and vomiting was lower than in the literature, but it cannot be said that this is due to the abbreviation of fasting. It can provide greater comfort, with the possibility of PONV prevention in patients at risk for these episodes.

scholarly journals Is Infusion of Subhypnotic Propofol as Effective as Dexamethasone in Prevention of Postoperative Nausea and Vomiting Related to Laparoscopic Cholecystectomy? A Randomized Controlled Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Mine Celik ◽  
Aysenur Dostbil ◽  
Mehmet Aksoy ◽  
Ilker Ince ◽  
Ali Ahiskalioglu ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Controlled Trial ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Controlled Study ◽  
Control Group ◽  
Double Blind ◽  
Significant Difference ◽  
Group D

Background. Postoperative nausea and vomiting (PONV) is one of common complications in patients undergoing laparoscopic cholecystectomy (LC). Aim of this study was to compare the efficacy of subhypnotic (1 mg/kg/h) infusion of propofol with dexamethasone on PONV in patients undergoing LC.Methods. A total of 120 patients were included in this randomized, double-blind, placebo-controlled study. Patients were randomly assigned to 3 groups; patients of group dexamethasone (group D) were administrated 8 mg dexamethasone before induction of anesthesia, patients of group propofol (group P) were infused to subhypnotic (1 mg/kg/h) propofol during operation and patients of group control (group C) were applied infusion of 10% intralipid. The incidence of PONV and needs for rescue analgesic and antiemetic were recorded in the first 24 h postoperatively.Results. In the 0–24 h, the incidence of PONV was significantly lower in the group D and group P compared with the group C (37.5%, 40%, and 72.5%, resp.). There was no significant difference in the incidence of PONV and use of antiemetics and analgesic between group D and group P.Conclusion. We concluded that infusion of propofol 1 mg/kg/h is as effective as dexamethasone for the prevention of PONV during the first 24 hours after anesthesia in patients undergoing LC.

scholarly journals Comparison of Ondansetron and Granisetron Effects for Prevention of Nausea and Vomiting Following Strabismus Surgery

2019 ◽  
Vol 7 (19) ◽  
pp. 3195-3200
Author(s):  
Shirin Salajagheh ◽  
Soodeh Kuhestani ◽  
Mahdieh Sharifzadeh Kermani ◽  
Omid Taheri ◽  
Naeimeh Naeimi Bafghi
Keyword(s):  
Postoperative Nausea ◽  
Rating Scale ◽  
Intervention Group ◽  
Postoperative Nausea And Vomiting ◽  
Strabismus Surgery ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Chi Square ◽  
Double Blind ◽  
Significant Difference

BACKGROUND: Postoperative nausea and vomiting (PONV) is a common complaint after strabismus surgery that leads to unpleasantness, increased hospitalisation time and increased costs. In severe cases, it can lead to dehydration, electrolyte disturbances, aspiration, pneumonia, and even sutures opening. AIM: This study was conducted to compare the effects of both ondansetron and granisetron on the reduction of PONV after strabismus surgery. METHODS: This randomised, and the double-blind clinical study was conducted on patients with ASA I and II undergoing strabismus surgery with age over 3 years old in Shafa Hospital, Kerman University of Medical Sciences during 2017 under general anaesthesia. Patients with inclusion criteria were randomly assigned to one of three groups including Ondansetron (A), Granisetron (B) and control group (C). Matching cases and controls on drugs were fully completed. Furthermore, 100 μg/kg of Ondansetron was intravenously injected, followed by injection of 40 μg/kg Granisetron for another intervention group. All patients underwent the same anaesthetic procedure and intravenous injection of drugs during anaesthesia induction. The severity of nausea and vomiting in recovery, 6 and 18 hours after the operation were verified according to the Verbal Rating Scale (VRS). Our data were analysed by Chi-square, ANOVA and TUKEY tests via SPSS version 18. RESULTS: There was no significant difference between the three groups in terms of age and sex. The incidence of postoperative nausea in recovery among three groups of A, B and C was determined to be 15, 7.5 and 37.5%, respectively. No significant difference was found between the two groups A and B (P = 0.68), although there was a significant difference between these two groups and group C (P < 0.05). The incidence of nausea at 6 hours after surgery in groups A, B and C was recorded as 40, 15 and 65% respectively, indicating that the incidence of nausea in group B was significantly lower than the other two groups, while showed a significant difference with group A (P = 0.039) and group C (P < 0.05). Also, the incident of nausea between groups was not statistically significant 18 hours after surgery (P < 0.05). Additionally, no significant difference was found in different groups in terms of vomiting incidence in recovery, 6 and 18 hours after surgery (P < 0.05). CONCLUSION: Our study suggests that Granisetron is more effective in preventing PONV during 6 hours after the surgery in comparison with Ondansetron which makes it a favourable alternative for preventing PONV.

scholarly journals Adding dexmedetomidine to morphine-based analgesia reduces early postoperative nausea in patients undergoing gynecological laparoscopic surgery: A randomized controlled trial

2019 ◽  
Author(s):  
Huai Jin Li ◽  
Shan Liu ◽  
Zhiyu Geng ◽  
Xue Ying Li
Keyword(s):  
Laparoscopic Surgery ◽  
Postoperative Nausea ◽  
Controlled Trial ◽  
High Risk Patient ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Controlled Study ◽  
Control Group ◽  
Loading Dose ◽  
Double Blind

Abstract Background: Few studies have investigated the effect of dexmedetomidine on postoperative nausea and vomiting (PONV) in patients underwent gynecological laparoscopic surgery. We investigated if adding dexmedetomidine to a morphine-based patient-controlled analgesia (PCA) could decrease the incidence of PONV in this high-risk patient population. Methods: In this prospective, randomized, double-blind and placebo-controlled study, 122 patients underwent gynecological laparoscopic surgery were assigned into two groups. Patients in the dexmedetomidine group (Group Dex) received a loading dose of dexmedetomidine 0.4μg/kg before the end of surgery, followed by morphine 0.5mg/ml plus dexmedetomidine 1μg/ml for postoperative i.v. PCA. Patients in the control group (Group Ctrl) received normal saline before the end of surgery, followed by morphine 0.5mg/ml alone for postoperative i.v. PCA. PCA pump was programmed as followed: bolus dose 2ml, lockout interval 8 minutes and background infusion at a rate of 1ml/h. The primary outcome was the incidence of nausea and vomiting within the first postoperative 24 hours. Results: Although there were no significant differences in regard to the total incidence of PONV (41.0% vs 52.5%, P=0.204), PONV score, time to first onset of PONV, or the need for rescue antiemetics within the first postoperative 24 hr between the two groups, the incidence of nausea and total PONV during the first 2h period was significantly lower in the Group Dex than in the Group Ctrl (9.8% vs 24.6%, P=0.031 and 0.031, respectively). More patients in Group Dex were over sedated or had bradycardia during the PACU compared with Group Ctrl (P=0.040 and 0.036, respectively). Conclusion: Adding dexmedetomidine to morphine-based PCA with a loading dose might reduce the incidence of early postoperative nausea but not total PONV within 24h after surgery in patients undergoing gynecological laparoscopic surgery.

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 Penehyclidine for prevention of postoperative nausea and vomiting following bimaxillary orthognathic surgery: a randomized, double-blind, controlled trial

2021 ◽  
Author(s):  
Li-Kuan Wang ◽  
Tong Cheng ◽  
Xu-Dong Yang ◽  
Guo-Li Xiong ◽  
Nan Li ◽  
...  
Keyword(s):  
Continuous Infusion ◽  
Postoperative Nausea ◽  
Low Dose ◽  
Controlled Trial ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Emergence Agitation ◽  
Double Blind ◽  
Infusion Group

Abstract Purpose To investigate the efficacy and safety of low-dose bolus plus continuous infusion of penehyclidine in preventing postoperative nausea and vomiting (PONV) following bimaxillary surgery. Methods Three hundred fifty-four patients were randomly allocated into three groups. In the Control group, placebo (normal saline) was injected before anesthesia and infused over 48 h after surgery; in the Bolus group, 0.5 mg penehyclidine was injected before anesthesia, whereas placebo was infused after surgery; in the Infusion group, 0.25 mg penehyclidine were injected before anesthesia, another 0.25 mg penehyclidine was infused after surgery. The primary endpoint was the incidence of PONV within 72 h. Results A total of 353 patients were included in intention-to-treat analysis. The PONV incidence was 61.0% (72/118) in the Control group, 40.2% (47/117) in the Bolus group, and 28.0% (33/118) in the Infusion group. The incidence was significantly lower in the Bolus group than in the Control group (RR 0.66; 95% CI 0.51–0.86; adjusted P = 0.003) and in the Infusion group than in the Control group (RR 0.46; 95% CI 0.33–0.63; adjusted P < 0.001); the difference between the Infusion and Bolus groups was not statistically significant (RR 0.70; 95% CI 0.48–1.00; adjusted P = 0.144). Emergence agitation occurred more frequently in the Bolus group than in the Control group (36.8% [43/117] vs. 21.2% [25/118], adjusted P = 0.027), but did not differ significantly between the Infusion and Control groups. Conclusions A low-dose bolus plus continuous infusion of penehyclidine was effective in preventing PONV without increasing emergence agitation. Trial registration Clinicaltrials.gov. Identifier: NCT04454866.

scholarly journals Low-Dose Mannitol Pretreatment Reduces Postoperative Nausea And Vomiting In Patients Undergoing Gynaecological Laparoscopic Surgery: A Randomized, Double-Blind, Placebo-Controlled Trial 

2020 ◽  
Author(s):  
Hui Xian Cheng ◽  
Gao Jie Li ◽  
Jie Ding ◽  
Wen Jun Guo
Keyword(s):  
Laparoscopic Surgery ◽  
Postoperative Nausea ◽  
Low Dose ◽  
Controlled Trial ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Clinical Trial Registry ◽  
Position Change ◽  
Double Blind

Abstract Background: Postoperative nausea and vomiting (PONV) is the most common and undesirable complications associated with anaesthesia, leading to discomfort in patients and extended hospital stays. The present study evaluates and compares the effects of preoperative low-dose mannitol infusion on PONV in patients undergoing gynaecological laparoscopic surgery.Methods: Fifty-three patients were randomly allocated into 2 groups (mannitol group, Group M, and control group, Group C). In the group M, low dose of 20% mannitol (0.5g/kg) was applied 30 minutes before induction. In the group C, equal volume of 0.9% normal saline was infused. Both groups were maintained with Ringer’s lactate in 8 ml/kg/h intraoperatively. The primary endpoint was the incidence and severity of PONV within the first postoperative 24h. The secondary endpoints were the average vascular resistance indexes(RI) and angle-corrected time-averaged flow velocity(TIMV)of bilateral vertebral artery (VA) and internal carotid artery (ICA) and cerebral blood flow volume (CBFV) using non-invasive Doppler ultrasound at time points just 5 min after laryngeal mask airway placement (T1：baseline);pneumoperitoneum started and position changed(T2);15 minutes after pneumoperitoneum with the position change (T3); pneumoperitoneum stopped with a position change (T4);15 minutes after pneumoperitoneum had stopped (T5).Results: Within 24h after operation, the incidence of PONV in group M (28.0%) was significantly lower than group C (56.0%) (P=0.045). Compared with group C, the severity of PONV in group M was significantly lower(P=0.040). The RI of VA and ICA were statistically different between the two groups(P<0.05).No significant differences were observed in the VM of VA and ICA and CBFV between the two groups(P＞0.05).Conclusion: Pretreatment with a low dose of mannitol effectively reduced the incidence and severity of PONV in patients undergoing laparoscopic gynecological surgery by reducing the RI of the VA and ICA.Trial registration: Chinese Clinical Trial Registry (ChiCTR-IPR-16007749, registered date: 12/01/2016.), http://www.chictr.org.cn

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