scholarly journals Comparison of the effects of low dose methylprednisolone and metoclopramide on nausea and vomiting and respiratory complications after adenotonsillectomy in children

2020 ◽  
Vol 24 (5) ◽  
Author(s):  
Ali Bestemi Kepekci ◽  
Bugra Subasi ◽  
Ahmet Hamdi Kepekci ◽  
Aziz Yarbil
Keyword(s):  
Low Dose ◽  
Oral Intake ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
High Rate ◽  
Late Period ◽  
Respiratory Complications ◽  
Analgesic Requirement ◽  
Pediatric Age Group ◽  
Significant Difference

Aim: Since tonsillectomies and/or adenoidectomies performed in the pediatric age group under general anesthesia have a high rate of postoperative nausea and vomiting (PONV), the practice of using prophylactic antiemetic drugs is common. This study aimed to compare the benefits of systemic administration of a low dose of inj. methylprednisolone 1 mg/kg with inj. metoclopramide 0.15 mg/kg IV for the prevention of PONV in children undergoing adenotonsillectomy. Methodology: In this study, the files of children undergone adenotonsillectomy from August 2015 to January 2018 in our hospital were analyzed retrospectively. 408 children aged 4-12 years were included in the study. Patients who were given methylprednisolone 1 mg/kg IV as premedication were placed in Group P, and patients who received metoclopramide 0.15 mg/kg were grouped as Group M. Effects on PONV, vomiting episodes, oral intake time, postoperative analgesic requirement, postoperative respiratory complications, and drug side effects were recorded. Results: Vomiting rates between 1-4 hrs (late period) were 11.0% in Group M (n = 22); It was 3.8% (n = 8) in Group P. In the late period, a significant difference was found between the two groups in terms of nausea and vomiting (p = 0.02, p = 0.07, respectively). In Group M, the incidence of respiratory complications was also higher in the postoperative period compared to Group P. Postoperative acetaminophen requirement increased significantly in group M compared to Group P (p = 0.006). Conclusion: Prophylactic use of a single dose of methylprednisolone 1 mg/kg IV during the preoperative period was more effective in reducing the incidence of late postoperative vomiting compared to metoclopramide and led to earlier tolerance of oral intake. In addition to its anti-inflammatory properties and antiemetic effects, low-dose methylprednisolone is also useful for prevention of respiratory complications. Key words: Methylprednisolone; Metoclopramide Hydrochloride; PONV; Respiratory complications; Tonsillectomy Citation: Kepekci AB, Subasi B, Kepekci AH, Yarbil A. Comparison of the effects of low dose methylprednisolone and metoclopramide on nausea and vomiting and respiratory complications after adenotonsillectomy in children. Anaesth. pain intensive care 2020;24(5): Received: 29 July 2020, Reviewed: 22 September 2020, Revised: 30 August 2020, Accepted: 2 October 2020

Comparison of the Effects of Low Dose Methylprednisolone and Metoclopramide on Nausea and Vomiting and Respiratory Complications after Adenotonsillectomy

2021 ◽  
Vol 15 (9) ◽  
pp. 2753-2756
Author(s):  
Shahid Adalat Chaudhry ◽  
Madiha Zafar ◽  
Usman Zeeshan ◽  
Mubashar Iqbal ◽  
Arooj Fatima ◽  
...  
Keyword(s):  
Side Effects ◽  
Pain Score ◽  
Low Dose ◽  
Operative Time ◽  
Oral Intake ◽  
Respiratory Complications ◽  
Group I ◽  
Male Patients ◽  
Group Ii ◽  
Mean Time

Objective: The aim of this study is to compare the effects of low dose methylprednisolone and metoclopramide on nausea, vomiting and respiratory complications after adenotonsillectomy. Study Design: Retrospective study Place and Duration: The study was conducted in Divisional Headquarter Teaching Hospital, Mirpur AJK for duration of six months from December 2020 to May 2021. Methods: Total 150 patients of both genders underwent adenotonsillectomy presented in this study. Patients were aged between 3-15 years. Detailed demographics of enrolled cases age, sex and weight were recorded after taking informed written consent. Patients were equally divided into two groups. Group I had 75 patients and received 1 mg/kg IV methylpredinosolone and group II received 0.15 mg/kg metoclopramide among 75 patients. Post-operative effects on PONV were assessed and compared among both groups in terms of oral intake time, vomiting episodes, respiratory complications and side effects. Mean pain score was calculated by VAS. Complete data was analyzed by SPSS 23.0 version. Results: There were 40 (53.3%) females and 35 (46.7%) males in group I with mean age 9.43±1.44 years while in group II 42 (56%) were females and 33 (44%) were male patients with mean age 8.04±3.36 years. Mean weight of the patients in group I was 23.08±4.61 kg and in group II mean body weight was 22.11±6.84 kg. Mean operative time in group I was 27.41±8.53 min and in group II mean time was 28.17±6.34 min. Post-operative frequency of vomiting and nausea was lower in group I 14 (18.7%) and 16 (21.3%) as compared to group II 21 (28%) and 24 (34%). Low pain score was found in group I 1.71±6.11 as compared to group II 3.02±4.09. Time to oral intake was higher in group II 2.98±3.48 hours as compared to group I 1.09±7.51 hours. Rate of respiratory complications and side effects were significantly higher in group II. Conclusion: We concluded in this study that the use of methylpredinosolone was effective among patients those underwent for adenotonsillectomy in terms of post-operative frequency of PONV, pain, respiratory complications and side effects. Except this low dose of methylpredinosolone were effective in earlier tolerance of oral intake. Keywords: Adenotonsillectomy, Metoclopramide, Methylpredinosolone, Oral Intake

scholarly journals Lack of Efficacy of Propofol in the Treatment of Early Postoperative Nausea and Vomiting

1998 ◽  
Vol 26 (4) ◽  
pp. 366-370 ◽  
Author(s):  
I. Harper ◽  
E. Della-Marta ◽  
H. Owen ◽  
J. Plummer ◽  
A. Ilsley
Keyword(s):  
Low Dose ◽  
Dose Range ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Test Drug ◽  
Gynaecological Surgery ◽  
Treatment Groups ◽  
Sedation Scores ◽  
To Receive ◽  
Rescue Antiemetic

The anti-nauseant efficacy of low-dose propofol was investigated in a blinded, randomized trial. Patients who complained of nausea and/or vomiting following laparoscopic gynaecological surgery and who requested antiemetic were randomly assigned to receive placebo, propofol 3 mg, propofol 9 mg or propofol 27 mg by intravenous injection. Nausea, vomiting and sedation were recorded by a blinded observer for 90 minutes following administration of the test drug, prior to discharge, and 24 hours following surgery. Rescue antiemetic (droperidol 1.0 mg IV) was available from 10 minutes after administration of test drug. Propofol failed to reduce nausea scores and did not reduce the incidence of vomiting. Numbers of patients receiving rescue antiemetic were similar in the four treatment groups. In the first 10 minutes following test drug administration, sedation scores were increased by propofol in a dose-related manner. We conclude that, in the dose range studied, propofol is ineffective for the treatment of nausea and vomiting occurring soon after laparoscopic gynaecological surgery.

scholarly journals Granisetron versus Granisetron-Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Pediatric Strabismus Surgery: A Randomized Double-Blind Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Renu Sinha ◽  
Dilip Shende ◽  
Souvik Maitra ◽  
Neeraj Kumar ◽  
Bikash Ranjan Ray ◽  
...  
Keyword(s):  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Complete Response ◽  
Strabismus Surgery ◽  
Nausea And Vomiting ◽  
Fisher Exact Test ◽  
Double Blind ◽  
Exact Test ◽  
Oculocardiac Reflex ◽  
Significant Difference

Aim.Efficacy of granisetron and combination of granisetron and dexamethasone was evaluated for prevention of postoperative nausea and vomiting (PONV) in children undergoing elective strabismus surgery.Methods.A total of 136 children (1–15 years) were included. Children received either granisetron (40 mcg/kg) [group G] or combination of granisetron (40 mcg/kg) and dexamethasone (150 mcg/kg) [group GD]. Intraoperative fentanyl requirement and incidence and severity of oculocardiac reflex were assessed. PONV severity was assessed for first 24 hours and if score was >2, it was treated with metoclopramide. Postoperative analgesia was administered with intravenous fentanyl and ibuprofen.Results.The demographic profile, muscles operated, and fentanyl requirement were comparable. Complete response to PONV in first 24 hours was observed in 75% (51/68) of children in group G and 76.9% (50/65) of children in group GD, which was comparable statistically (p=0.96, Fisher exact test; OR 1.11, 95% CI 0.50, 2.46). Incidence of PONV between 0 and 24 hours was comparable. One child in group G required rescue antiemetic in first 24 hours and none of the children had severe PONV in group GD. There was no significant difference in incidence or severity of oculocardiac reflex.Conclusion.Dexamethasone did not increase efficacy of granisetron for prevention of PONV in elective pediatric strabismus surgery. Registration number of clinical trial wasCTRI/2009/091/001000.

scholarly journals Effects of palonosetron and ondansetron on preventing nausea and vomiting after laparoscopic surgery

2017 ◽  
Vol 46 (1) ◽  
pp. 411-420 ◽  
Author(s):  
Qili Liu ◽  
Chengmao Zhou ◽  
Zeqing Bao ◽  
Yu Zhu
Keyword(s):  
Laparoscopic Surgery ◽  
Meta Analysis ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Cochrane Library ◽  
Time Intervals ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled ◽  
Significant Difference ◽  
The Cochrane Library

Background This meta-analysis was performed to evaluate the efficacy and safety of palonosetron and ondansetron in preventing postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic surgery with general anesthesia. Methods We searched for randomized controlled clinical trials in PubMed, Embase, and The Cochrane Library. Results Nine studies were enrolled in this meta-analysis and showed no statistically significant difference between palonosetron and ondansetron in the prevention of PONV in the first 24 hours after surgery (relative risk [RR], 0.62; 95% confidence interval [CI], 0.35–1.10). Palonosetron more effectively prevented vomiting at various time intervals during the first 24 hours postoperatively than did ondansetron: 0–2 hours (RR, 0.45; 95% CI, 0.26–0.78), 2–6 hours (RR, 0.74; 95% CI, 0.39–1.40), and 6–24 hours (RR, 1.20; 95% CI, 0.55–2.64). No significant differences in side effects were found between palonosetron and ondansetron (RR, 0.67; 95% CI, 0.40–1.14). Conclusion This meta-analysis demonstrated that palonosetron is not more efficacious than ondansetron in the prevention of early PONV. However, palonosetron was more efficacious than ondansetron in the prevention of vomiting after laparoscopic surgery.

scholarly journals Low-dose dexamethasone effectively prevents postoperative nausea and vomiting after ambulatory laparoscopic surgery

2001 ◽  
Vol 48 (10) ◽  
pp. 973-977 ◽  
Author(s):  
Jeng-Chai Huang ◽  
Ja-Ping Shieh ◽  
Chao-Shun Tang ◽  
Jann-Inn Tzeng ◽  
Koung-Shing Chu ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Postoperative Nausea ◽  
Low Dose ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting

Prolongation of QTc Interval after Postoperative Nausea and Vomiting Treatment by Droperidol or Ondansetron

2005 ◽  
Vol 102 (6) ◽  
pp. 1094-1100 ◽  
Author(s):  
Beny Charbit ◽  
Pierre Albaladejo ◽  
Christian Funck-Brentano ◽  
Mathieu Legrand ◽  
Emmanuel Samain ◽  
...  
Keyword(s):  
Postoperative Nausea ◽  
Low Dose ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Qtc Interval ◽  
Interval Prolongation ◽  
Antiemetic Drug ◽  
Electrocardiographic Monitoring ◽  
Qtc Interval Prolongation ◽  
Type 3

Background At dosages above 0.1 mg/kg, droperidol induces a dose-dependent QTc interval prolongation. Although subject to controversy, low-dose droperidol has recently been suspected to induce cardiac arrhythmias. Hence, 5-hydroxytryptamine type 3 antagonists have become the first-line drug for management of postoperative nausea and vomiting. These drugs are also known to prolong the QTc interval at high dosages. This study describes QTc interval changes associated with postoperative nausea and vomiting treatment by droperidol or ondansetron at low doses. Methods Eighty-five patients with postoperative nausea and vomiting were included in this prospective, single-blind study. Patients received either 0.75 mg intravenous droperidol (n = 43) or 4 mg intravenous ondansetron (n = 42). Electrocardiographic recordings were obtained before administration of antiemetic drug and then 1, 2, 3, 5, 10, and 15 min after. Electrocardiographic monitoring was maintained for 3 h in eight patients in each group. Results The QTc interval was prolonged (> 450 ms in men, > 470 ms in women) in 21% of the patients before antiemetic drug administration. This was significantly correlated with lower body temperature and longer duration of anesthesia. Compared with predrug QTc measurement, both antiemetics were associated with a significant QTc interval prolongation (P < 0.0001). The mean maximal QTc interval prolongation was 17 +/- 9 ms after droperidol occurring at the second minute and 20 +/- 13 ms after ondansetron at the third minute (both P < 0.0001). Compared with predrug measurement, the QTc interval was significantly lower after the 90th minute in both groups. Conclusions Droperidol and ondansetron induced similar clinically relevant QTc interval prolongations. When used in treatment of postoperative nausea and vomiting, a situation where prolongation of the QTc interval seems to occur, the safety of 5-hydroxytryptamine type 3 antagonists may not be superior to that of low-dose droperidol.

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