scholarly journals Perbandingan antara ondansetron 4 mg iv dan deksametason 5 mg iv dalam mencegah mual-muntah pada pasien laparotomi dengan anestesia umum

e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Sitti I. Yanhil ◽  
Barry I. Kambey ◽  
Harold F. Tambajong
Keyword(s):  
General Anesthesia ◽  
Postoperative Nausea ◽  
Random Sampling ◽  
Analytical Study ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Treatment Groups ◽  
Drug Of Choice ◽  
Dexamethasone Group ◽  
Significant Difference

Abstract: Nausea and vomiting are the most frequent side effects which occur postoperatively as a result of general anesthesia. Postoperative nausea and vomiting may increase morbidity and extend the duration of patient to stay at the recovery room. Ondansetron drug that has the effect as 5-HT3 antagonist receptor and dexamethasone administration might be the drug of choice in preventing postoperative nausea and vomiting. This study was aimed to compare the effect of 4 mg ondansetron and 5 mg dexamethasone administration on the incidence of postoperative nausea and vomiting in laparotomy surgery with general anesthesia. This was a prospective analytical study with an experimental method. Samples were obtained by using consecutive random sampling. There were 32 patients aged 18 to 60 years old, ASA I-II clasification, divided into two treatment groups as follows: ondansetron group given at the end of operation and dexamethasone group given before the induction of anesthesia. The resultas showed that complaints of postoperative nausea and vomiting mostly occured at the 5 mg dexamethasone group (37.5%) rather than 4 mg ondansetron group (12.5%). The Mann-Whitney test showed that there were no significant difference between both groups (p>0.05). Conclusion: Administration of 4 mg ondansetron intravenously has the same effectivity as 5 mg dexamethasone intravenously in reducing the incidence of postoperative nausea and vomiting after laparotomy with general anesthesia. Keywords: nausea and vomiting, ondansetron, dexamethasone Abstrak: Mual-muntah merupakan efek samping yang paling sering didapatkan pasca operasi akibat pemberian anestesia umum. Mual-muntah pasca operasi dapat meningkatkan morbiditas dan memperpanjang masa rawat pasien dari ruang pulih. Pemberian obat ondansetron yang berefek 5-HT3 reseptor dan deksametason dapat menjadi obat pilihan dalam mencegah terjadinya mual muntah pascaoperasi. Penelitian ini bertujuan untuk membandingkan pemberian ondanetron 4 mg dan deksametason 5 mg terhadap kejadian mual-muntah pasca operasi pada bedah laparotomi dengan anestesia umum. Jenis penelitian ialah analitik prospektif dengan metode eksperimental. Sampel didapatkan secara consecutive random sampling yang dilakukan pada 32 pasien dengan rentang usia 18-60 tahun, klasifikasi ASA I-II, yang dibagi menjadi dua kelompok perlakuan: kelompok ondansetron yang diberikan di akhir operasi dan kelompok deksametason sebelum induksi anestesia. Hasil penelitian mendapatkan keluhan mual muntah pascaoperasi lebih banyak terjadi pada kelompok deksametason 5 mg (37,5%) dibandingkan kelompok ondansetron 4 mg (12,5%). Uji Mann-Whitney mendapatkan tidak ada perbedaan bermakna antara keduanya (p >0,05). Simpulan: Pemberian ondansetron 4 mg intravena memiliki efektivitas yang sama dengan deksametson 5 mg iv dalam menurunkan kejadian mual-muntah pasca operasi laparotomi dengan anestesia umum.Kata kunci: mual muntah, ondansetron, deksametason

Inspired Oxygen Fraction of 0.8 Does Not Attenuate Postoperative Nausea and Vomiting after Strabismus Surgery

2005 ◽  
Vol 103 (1) ◽  
pp. 6-10 ◽  
Author(s):  
Tanja A. Treschan ◽  
Christian Zimmer ◽  
Christoph Nass ◽  
Bernd Stegen ◽  
Joachim Esser ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Intravenous Administration ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Strabismus Surgery ◽  
Nausea And Vomiting ◽  
Controlled Study ◽  
Oxygen Fraction ◽  
Significant Difference ◽  
Inspired Oxygen

Background Postoperative nausea and vomiting (PONV) is a distressing problem after strabismus surgery. An inspired oxygen fraction has been reported to decrease PONV in patients after colon resection and to be more effective than ondansetron after gynecologic laparoscopy. Therefore, in a randomized, prospective, placebo-controlled study, the authors tested whether an inspired oxygen fraction of 0.8 decreases PONV in patients undergoing strabismus surgery and whether oxygen is more effective than ondansetron. Methods With approval of the authors' institutional review board, 210 patients were randomly assigned to receive one of three treatments: (1) 30% inspired oxygen in air plus intravenous administration of saline, (2) 80% inspired oxygen in air plus intravenous administration of saline, or (3) 30% inspired oxygen in air plus 75 microg/kg ondansetron intravenously during induction. General anesthesia was standardized and included etomidate, alfentanil, and mivacurium for induction and sevoflurane for maintenance. PONV was evaluated 6 and 24 h postoperatively by an investigator unaware of treatment assignment. Results Overall postoperative incidence of nausea and vomiting was 41% for inspired oxygen fraction of 0.3 plus placebo, 38% for inspired oxygen fraction of 0.8 plus placebo, and 28% for inspired oxygen fraction of 0.3 plus ondansetron, respectively (P = 0.279). Therefore, there was no statistically significant difference of PONV incidence among groups. Conclusions An inspired oxygen fraction of 0.8 during general anesthesia with sevoflurane does not decrease PONV in patients undergoing strabismus repair. Ondansetron also did not significantly decrease PONV in our study setting.

scholarly journals A Comparative Study of Single Dose Dexamethasone versus Ondansetron for control of Post Operative Nausea and Vomiting after High-Risk Surgeries

2020 ◽  
Vol 8 (1) ◽  
pp. 64-70
Author(s):  
Ashwin Joginipally ◽  
Nikhil Mudgalkar
Keyword(s):  
High Risk ◽  
General Anesthesia ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Age Group ◽  
Dexamethasone Group ◽  
Group I ◽  
Group Ii ◽  
Post Operative Nausea

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

scholarly journals Effects of lidocaine, dexmedetomidine, and their combination infusion on postoperative nausea and vomiting following laparoscopic hysterectomy: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Siqi Xu ◽  
Shengbin Wang ◽  
Shenghong Hu ◽  
Xia Ju ◽  
Qing Li ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Continuous Infusion ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Laparoscopic Hysterectomy ◽  
Nausea And Vomiting ◽  
Bolus Infusion ◽  
Significant Difference ◽  
Vas Scores ◽  
Pacu Stay

Abstract Background A few studies have reported that administration of lidocaine and dexmedetomidine relieves the incidence of postoperative nausea and vomiting (PONV). We explored whether combined infusion of lidocaine plus dexmedetomidine had lower occurrence of PONV undergoing laparoscopic hysterectomy with general anesthesia. Methods A total of 248 women undergoing elective laparoscopic hysterectomy were allocated into the following four groups: the control group (group C, n = 62) received an equal volume of saline, the lidocaine group (group L, n = 62) received intravenous lidocaine (bolus infusion of 1.5 mg/kg over 10 min, 1.5 mg/kg/h continuous infusion), the dexmedetomidine group (group D, n = 62) received dexmedetomidine administration (bolus infusion of 0.5 µg/kg over 10 min, 0.4 µg/kg/h continuous infusion), and the lidocaine plus dexmedetomidine group (group LD, n = 62) received combination of lidocaine (bolus infusion of 1.5 mg/kg over 10 min, 1.5 mg/kg/h continuous infusion) and dexmedetomidine administration (bolus infusion of 0.5 µg/kg over 10 min, 0.4 µg/kg/h continuous infusion). The primary outcome was the incidence of nausea, vomiting, and PONV during the first 48 h after surgery. The secondary outcomes included the incidence of total 24 h PONV after surgery, intraoperative remifentanil requirement, postoperative pain visual analogue scale (VAS) scores and fentanyl consumption, the incidence of bradycardia, agitation, shivering, and mouth dry during post-anesthesia care unit (PACU) stay period. Results The occurrence of nausea and PONV in group LD (5.0 and 8.3%) at 0–2 h after operation was lower than group C (21.7 and 28.3%) (P < 0.05). There was no statistically significant difference with respect to occurrence of nausea and PONV in groups L (13.3 and 20.0%) and D (8.3 and 13.3%) at 0–2 h after operation compared to group C (21.7 and 28.3%). The incidence of nausea, vomiting, and PONV at 2–24 and 24–48 h after surgery in all four groups was not statistically significant. The incidence of total 24 h PONV in group LD (33.3%) was significantly decreased compared to group C (60.0%) (P < 0.05). The cumulative consumption of fentanyl at 6 and 12 h after surgery was significantly reduced in group LD compared to other three groups (P < 0.05). The pain VAS scores were significantly decreased at 2, 6, and 12 h after operation in group LD compared to other three groups (P < 0.05). Remifentanil dose in the intraoperative period was significantly lower in groups LD and D compared with groups C and L (P < 0.05). The number of mouth dry, bradycardia, and over sedation during the PACU stay period was markedly increased in group LD (28.3, 30.0, and 35.0%, respectively) compared with groups C (1.7, 1.7, and 3.3%, respectively) and L (3.3, 5.0, and 6.7%, respectively) (P < 0.05). Conclusions Lidocaine combined with dexmedetomidine infusion markedly decreased the occurrence of nausea and PONV at 0–2 h as well as the total 24 h PONV. However, it significantly increased the incidence of mouth dry, bradycardia, and over sedation during the PACU stay period after laparoscopic hysterectomy with general anesthesia. Trial registration ClinicalTrials.gov (NCT03809923), registered on January 18, 2019.

Effect of Palonosetron, Dexamethasone, or Palonosetron and Dexamethasone in Postoperative Nausea and Vomiting in Highly Susceptible Thyroidectomy Patients: A Randomized Trial

2016 ◽  
Vol 101 (3-4) ◽  
pp. 106-115
Author(s):  
Min Kyoung Kim ◽  
Hyun Kang ◽  
Geun Joo Choi ◽  
Jong In Oh ◽  
So Young Yang ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Patient Controlled Analgesia ◽  
Dexamethasone Group ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Group D ◽  
Rescue Antiemetic

Our study aimed to compare the efficacy of dexamethasone added to palonosetron to both palonosetron and dexamethasone monotherapy for preventing postoperative nausea and vomiting in highly susceptible patients receiving opioid-based, intravenous patient-controlled analgesia after thyroidectomy. Nonsmoking women who underwent total thyroidectomy were randomly allocated to either the dexamethasone group (Group D), the palonosetron group (Group P), or to the dexamethasone plus palonosetron group (Group DP). The severity of nausea and pain, the number of episodes of vomiting, the administrations of rescue anti-emetics, and the side effects of the antiemetics were documented in the recovery room at 2, 4, 8, 12, 24, and 48 hours after surgery. The severity of nausea was lowest in Group DP, followed by Group P and Group D. But there was an overall difference only between Group D and Group DP. The overall differences in the time to the first administration of the rescue antiemetic were observed in a Kaplan-Meier analysis (P = 0.017), noting a significant difference between Group D and Group DP (P = 0.003). The combination of dexamethasone and palonosetron decreased the severity of nausea and increased the time to the first antiemetic dose compared with using dexamethasone or palonosetron alone in nausea-susceptible patients undergoing thyroidectomy.

scholarly journals Opioid-Free General Anesthesia with Dexmedetomidine-Esketamine-Lidocaine Versus Opioid-Based General Anesthesia with Sufentanil-Remifentanil for Breast Benign Patients Undergoing Lumpectomy

2021 ◽  
Author(s):  
Xiali Qian ◽  
Hongmei Yuan ◽  
Lin Zhao ◽  
Shanwu Feng ◽  
Yajie Chen ◽  
...  
Keyword(s):  
Adverse Events ◽  
General Anesthesia ◽  
Postoperative Nausea ◽  
Recovery Time ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Hemodynamic Parameters ◽  
Rescue Analgesia ◽  
Surgical Incision ◽  
Significant Difference

Abstract Background: Opioid-free anesthesia (OFA) is being implemented in breast benign lumpectomy due to increased awareness of opioid adverse effects and the national opioid crisis. The objective of this study was to examine the effect of Dexmedetomidine-Esketamine-Lidocaine OFA technique in breast benign lumpectomy and assess its impact on subjective pain, intraoperative hemodynamic parameters, adverse events versus standard opioid-based technique (OA).Methods: In this prospective, randomized study, sixty breast benign patients, aging from 20 to 60 years with American Society of Anesthesiologists physical status I or II, were scheduled to undergo lumpectomy. The patients were randomized to receive either OFA (OFA group) or opioid-based (OA group) anesthesia. Dexmedetomidine-Esketamine-Lidocaine or Sufentanil-Remifentanil was administered for induction and maintenance in OFA group or OA group, respectively. Intravenous flurbiprofen axate 50 mg was administered 10 minutes before the end of surgery, and dezocine 5 mg was given to patient showing visual analog scale (VAS) pain score≥4 at any point of time for postoperative rescue analgesia in both groups. Intraoperative hemodynamic parameters at the time points of entering operating room (T0), immediately after induction of anesthesia (T1), immediately after intubation (T2), 1 minute after surgical incision (T3), 5 minutes after surgical incision (T4), and 10 minutes after surgical incision (T5), number of vasoactive drugs required, awakening time and recovery time of orientation, postoperative pain VAS at 2 h, 12 h, and 24 h after recovery, number of postoperative rescue dezocine analgesia required, and incidence of adverse events were recorded.Results: The mean arterial pressure and heart rate at T1, T2, T3, T4, T5 were significantly lower in OA group than OFA group. The incidences of application of rescue ephedrine (1 of 30 [3.3%] versus 12 of 30 [40%], P=0.001) and rescue atropine (2 of 30 [6.7%] versus 6 of 30 [20%], P=0.038) were significantly lower in OFA group compared with OA group. The pain VAS scores at 2 h, 12 h, and 24 h after surgery and number of rescuing dezocine analgesia required (0 of 30 [0%] versus 0 of 30 [0%]) had no statistically significant difference between the two groups. Postoperative nausea and vomiting (3 of 30 [10%] versus 16 of 30 [53%], P=0.001) and application of rescue ondansetron (1 of 30 [3.3%] versus 10 of 30 [33%], P=0.003) were both less in the OFA group compared to those in OA group. However, compared with OA group, patients in OFA group had more delayed awakening time ([7.27±2.85] min versus [4.47±1.11] min, P=0.000) and prolonged recovery time of orientation. ([11.97±3.19] min versus [6.93±1.17] min, P=0.000).Conclusions: The combination of Dexmedetomidine-Esketamine-Lidocaine OFA technique may be an alternative anesthesia for breast benign lumpectomy as better hemodynamic stability, lower incidence of postoperative nausea and vomiting, and adequate postoperative analgesia compared with OA, although longer awakening time and longer recovery time of orientation.Trial registration number: ChiCTR2100044230 (http://www.chictr.org.cn/)

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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