scholarly journals Effect of Anti-Emetic Combination of Sevoflurane / Propofol Anesthesia Technique in Laparoscopic Cholecystectomy

2021 ◽  
Vol 12 (01) ◽  
pp. 03-07
Author(s):  
Muhammad Salman Maqbool ◽  
Muhammad Alam ◽  
Muhammad Umer Draz ◽  
Ayesha Shahid ◽  
Shumaila Ashfaq
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Study Design ◽  
Preoperative Assessment ◽  
Study Groups ◽  
Observation Time ◽  
Nausea And Vomiting ◽  
Physical Status ◽  
Anesthetic Induction ◽  
Group B ◽  
Post Operative Nausea

Objective: To assess symptoms of nausea and vomiting in laparoscopic cholecystectomy post-operatively, administered anesthesia by sevoflurane or propofol and to assess the effect of dexamethasone and ondansetron anti-emetic combination. Study design & Setting: It was an experimental study design conducted from 08-Oct-2017 till 11-Jul-2018 at Rawal General & Dental Hospital. Methodology: Patients were recruited in interventional groups by lottery method as n=160, with 80 cases allocated in each group. The patients with gallstones planned for laparoscopic cholecystectomy after preoperative assessment were classified to American Society of Anesthesiologist (ASA) physical status class I-II. All the patients placed in a particular ASA physical status class were (exposed to both induction methods) either anesthetic induction by propofol 1-2 mg/kg (group-A) or by employing sevoflurane 4-8% (group-B) in combination with oxygen, while maintenance was done in both study groups with 2% sevoflurane and 50% nitrous oxide in oxygen. After procedure patients stayed in post-anesthesia care unit where intra-operative monitoring was evaluated. The primary end point of the study was to note the rate of nausea and vomiting in 24 hours interval after surgery. Results: Both sevoflurane and propofol are equally effective anesthetic induction agents. The same combination of dexamethasone and ondansetron was given to both groups and so the actual effect of both anesthesia drugs in terms of side effects were nullified. Conclusion: In laparoscopic cholecystectomy, both sevoflurane and propofol are good enough when administered with dexamethasone and ondansetron anti-emetic combination, for post-operative nausea and vomiting up to 24 hours observation time in study.

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 Study of efficacy of combination of dexamethasone and ondansetron versus ondansetron alone using SAMBA guidelines for postoperative nausea and vomiting in laparoscopic cholecystectomy.

2020 ◽  
Vol 27 (09) ◽  
pp. 1839-1844
Author(s):  
Ali Arslan Munir ◽  
Abeera Zareen ◽  
Sumbal Rana
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Memory Loss ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Military Hospital ◽  
Significance Level ◽  
American Society ◽  
Group B ◽  
Post Operative Nausea ◽  
American Society Of Anesthesiologists

Objectives: Comparing the effectiveness of combining ondansetron and dexamethasone vs ondansetron unaided in amounts suggested by SAMBA strategies for stoppage of post-operative nausea and vomiting in laparoscopic cholecystectomy patients. Study Design: Randomized Control trial. Setting: Department of Anaesthesia, Combined Military Hospital, Rawalpindi. Period: Six months (April 2015–October 2015). Material & Methods: A sum of 160 patients were experimented by taking 80 in every group. Group A: of ondansetron. Group B: ondansetron plus dexamethasone. Significance level: 5% Test power: 80% Proportion of the projected population A is 72%1. Foreseen population percentage B is 88%1. Besides successive non-probability specimen system was taken for sample gathering. Patients who were selected were American society of anesthesiologists 1 & 2 while ones with struggle in communiqué e.g. psychologic issues, memory loss, loss of speech etc, pregnant and menstruating ladies3, known of PONV, motion disease, ear problems and vertigo, on long term steroid use3, anguished from diabetes mellitus, hiatal hernia were excluded. The frequency of side effects were duly scribed down and doses of drugs wrote down. Rescue anti vomiting was secondhand for ones of PONV. Results: We deduced that mixture of ondansetron & dexamethasone was effectual in averting post-operative nausea & vomiting equated to Ondansetron unaided. Conclusion: There is variance in incidence of PONV in mutual clusters with combination remedy of ondansetron plus dexamethasone being safer as equated to Ondansetron unaided.

scholarly journals Hyperglycemic Response of Non-diabetic Women Undergoing Abdominal Hysterectomy Who Have Received Prophylactic Dexamethasone to Alleviate Nausea and Vomiting

2020 ◽  
Author(s):  
Saghar Samimi Sadeh ◽  
Ehsan Bastanhagh ◽  
Somayeh Mohammadi ◽  
Reza Shariat Moharari ◽  
Pejman Pourfakhr ◽  
...  
Keyword(s):  
Normal Saline ◽  
Abdominal Hysterectomy ◽  
Nausea And Vomiting ◽  
Diabetic Patients ◽  
Anesthetic Induction ◽  
Double Blind ◽  
Group A ◽  
Group B ◽  
Post Operative Nausea

Background: This study has been designed to assess the hyperglycemic response in non-diabetic patients in women undergoing abdominal hysterectomy; who have received a prophylactic dose of dexamethasone to alleviate post-operative nausea and vomiting (PONV). Methods: This was a double blind randomized clinical trial involving seventy women who were candidates for abdominal hysterectomy. The women were randomly assigned into two groups. Group A received 8mgs (in 50 mls normal saline) of IV dexamethasone; post-anesthetic induction and pre-surgery. Group B received 50 mls of normal saline post-anesthetic induction and pre-surgery. Patients were asked whether they had any nausea and vomiting during recovery. The patients’ blood sugar (BS) levels were assessed before surgery, during recovery and then 1, 6, 12, 18, and 24 hours after surgery. Results: Thirty-three women in each group were monitored. Assessment of the results indicates that nausea and vomiting were not significantly different between the two groups. The age and BS before surgery of the patients were not significantly different. BS levels after surgery were significantly higher for the group receiving dexamethasone; with the exception of the levels during the first hour. Conclusion: The BS of women undergoing abdominal hysterectomy is significantly higher for those receiving a single dose of dexamethasone, post-operatively, compared to patients receiving a placebo. The finding of this study does not support the role of dexamethasone in the prophylactic anti-emetic treatment in abdominal hysterectomy.

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.  

RANDOMIZED COMPARATIVE STUDY OF ONDANSETRON AND COMBINATION OF ONDANSETRON AND DEXAMETHASONE, AS A PROPHYLAXIS OF POST-OPERATIVE NAUSEAAND VOMITING IN ADULTS UNDERGOING ELECTIVE LAPAROSCOPIC SURGERIES

2021 ◽  
pp. 48-49
Author(s):  
Rumani Ruku ◽  
Jasmeen Chowdhary
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Care ◽  
Demographic Variables ◽  
Nausea And Vomiting ◽  
Age Group ◽  
Patient Response ◽  
High Incidence ◽  
Group A ◽  
Group B ◽  
Post Operative Nausea

Background: Post-operative nausea and vomiting (PONV) is quite associated with laparoscopic surgery. In-spite of advances in surgery and post surgical care, nausea and vomiting still has a high incidence. This study was planned to explore the efcacy of a combination therapy of ondansetron with dexamethasone against PONVand compare the results with the efcacy of ondensetron-only. Method:Arandomized clinical trial study was conducted in the Department of Anesthesia, GMC Jammu, over a period of 6 months, on 50 patients in the age group of 18-50 years, of either gender, undergoing laparoscopic surgeries under general anesthesia. Patients were divided into two groups of 25 each: Group A received 4 mg of Ondansetron intravenously, while Group B received 4 mg of Ondansetron and 8 mg of Dexamethasone intravenously, soon after intubation. Results: The demographic variables of two groups were similar. While 19 (76%) patients showed post-operative nausea in Group A, while in Group B, only 8 (32%) patients experienced nausea, which was very signicant. Similarly, 11 (44%) patients showed post-operative vomiting in GroupAand only 2 (8%) complained of vomiting. 24% patients did not complain about any kind of nausea or vomiting in GroupA. Mild nausea was observedin60%patientsinGroupA,while amongonly32%patientsingroupB.Nocomplications of anykindwereobservedduringthisstudy. Conclusion: Ondensetron and dexamethasone, administered intravenously, after intubation, in laparoscopic surgery, is safe and has a better patient response in preventing post-operative nausea and vomiting.

scholarly journals Evaluating the Effect of Intraoperative Dextrose 10% Administration on Reducing Postoperative Nausea and Vomiting after Laparoscopic Surgery

2019 ◽  
Vol 13 (1) ◽  
pp. 78-85
Author(s):  
Ashraf Nabil Saleh ◽  
Dalia Fahmy Emam ◽  
Mohamed Mohamed Kamal
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Study Groups ◽  
Primary Objective ◽  
Nausea And Vomiting ◽  
Controlled Study ◽  
Double Blind ◽  
Female Patients ◽  
Medication Consumption

Background: Although PONV is usually self-limiting or is treated without sequelae, the incidence of PONV could be as high as 70% to 80% in high-risk populations such as female sex, obese patients, age younger than 40 years, nonsmoker patients, history of PONV or motion sickness. Objectives: The study aimed to investigate whether dextrose 10% decreases the incidence of postoperative nausea and vomiting in female patients undergoing laparoscopic cholecystectomy Materials and Methods: This prospective, double-blind randomized placebo-controlled study comprised 130 ASA physical status I and II nonsmoker female patients, 20-40 years of age, scheduled for laparoscopic cholecystectomy at Ain Sham University – Assembled operating theater from August 2018 to October 2018. Patients were arbitrarily divided into two study groups of 65 patients each. Group LR received lactated Ringer’s solution and group D received 10% dextrose. The primary objective of this study was to compare the incidence of PONV in the study treatment groups. The secondary outcomes included measurement of antiemetic medication consumption as well as blood glucose changes between groups. Results: 50 from a total of 65 participants (76.9%) in Lactated Ringer (LR) group experienced nausea. On the other hand, 30 participants only (46.2%) in dextrose (D) group were nauseated. This dissimilarity was statistically highly significant (P= 0.0003). Conclusion: In this study, dextrose 10% administration resulted in improved postoperative emesis management as explained by the lower incidence of nausea and rescue antiemetic consumption.

scholarly journals OUTCOME OF LAPAROSCOPIC CHOLECYSTECTOMY WITH &WITHOUT DRAIN

1969 ◽  
Vol 5 (1) ◽  
pp. 613-616
Author(s):  
MUHAMMAD ASLAM RAl ◽  
M FAWAD ASLAM ◽  
SARA ASLAM
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Prophylactic Antibiotic ◽  
Laparoscopic Approach ◽  
Preoperative Assessment ◽  
Open Conversion ◽  
Abdominal Drain ◽  
Port Infection ◽  
Group A ◽  
Group B

BACKGROUND: Cholecystitis is common health problem and laparoscopic approach to gallstonedisease is procedure of choice. Intra abdominal drain is used to pervert post operative sub hepaticcollection. However drain insertion may increase pain discomfort and delay in discharge.OBJECTIVE: To assess the benefits and harms of drain use in laparoscopic cholecystectomyMATERIAL AND METHODS: A prospective, single centre, Study conducted on 200 patients in needof laparoscopic cholecystectomy at Rai Medical Complex Sargodha (affiliated with Rai MedicalCollege) from April, 2009 to July 2011. All patients, after preoperative assessment, were operated undergeneral anesthesia. Prophylactic antibiotic, inj. cefuroxime 1.5 gm prior to anesthesia and two furtherdoses at 8 hour interval postoperatively were given in chronic cholecystitis and therapeutic doses, forseven days in acute cholecystitis. Patients having choledocholithiasis and open conversion wereexcluded from the study four port techniques were used for laparoscopic cholecystectomy. Patients weredivided randomly in to two groups, 100 patients in each Group A, without drain and group B with drain.Data was recorded on standardized performa.RESULTS: Out of 200 patients, 18 were male and 182 were female .Age range was 20 years to 90years. 02 patients from group B, having acute cholecystitis, had epigastric port infection on 15thpostoperative day. Drainage was done with uneventful healing. One patient from group A had s/hepaticabscess 03 weeks after surgery. Ultrasonographic guided aspiration was done in OPD with goodrecovery .No mortality, no open conversion and no CBD injury. Thirty patients from group A weredischarged within 24 hours , 3 patients having drain were discharged after 72 hours and all others fromboth groups within 48 hours.04 patients from group B had severe shoulder tip pain and relieved afterremoval of drain.Postoperative pain was significantly higher in patients who had drain placed, median VAS was 5(ranging 1-10) versus 3 in non drained group .Especially removal of drain was a painful procedure.CONCLUSION: Routine use of intra abdominal drain in laparoscopic cholecystectomy is of no benefitbut causes more discomfort to patient except in empyaema gallbladder.KEY WORDS: Laparoscopic cholecystectomy, intra abdominal drain.

Sign in / Sign up

Export Citation Format

Share Document